Valvular & structural heart diseaseCohort study
Risk factor profiles and haemodynamic progression in aortic stenosis: a retrospective population-based study
- Retrospective cohort study
- population-based
- integrated healthcare system
Authors' conclusion
AS progression varies by baseline severity and underlying risk profile. Incorporating clinical and echocardiographic risk factors into surveillance strategies may improve identification of patients most likely to benefit from closer monitoring or earlier intervention.
Study context
- Population
- Adults aged ≥18 years with ≥2 transthoracic echocardiograms performed ≥180 days apart between 2011 and 2021, Kaiser Permanente Southern Californiapatients contributing 111,189 TTE pairs
- Participants
- 70,850 adults
- Exposure
- Predictors of rapid progression, defined as an annualised increase in Vmax ≥0.3 m/s/year, by baseline severity
Main finding
As reported in the abstract
Rapid progression (annualised increase in Vmax ≥0.3 m/s/year)
Observational data: associations, not effects.
Further findings
Haemodynamic progression rates
- Mean annual increase in Vmax
- 0.1 m/s/year
- Mean gradient increase
- 1.6 mm Hg/year
- AVA decline
- 0.1 cm²/year
Predictors of rapid progression in aortic sclerosis
- Significantly associated with older age, anaemia, liver disease, renal failure, pulmonary disease, peripheral vascular disease, cancer and obesity
Predictors of rapid progression in mild aortic stenosis (AS)
- Anaemia and obesity remained significant, but echocardiographic parameters, including higher gradient and smaller AVA, were stronger predictors
Predictors of rapid progression in moderate AS
- Valve-related parameters predominated; clinical characteristics were not significantly associated with progression
Original publication
Risk factor profiles and haemodynamic progression in aortic stenosis: a retrospective population-based study. Heart. Published 10 April 2026. doi:10.1136/heartjnl-2025-327243
Summarised from the published abstract; every number is checked against it