J Cardiovasc Ultrasound.  2010 Dec;18(4):127-133. 10.4250/jcu.2010.18.4.127.

Progression Rate of Aortic Valve Stenosis in Korean Patients

• Ryu DR
• Park SJ
• Han H
• Lee HJ
• Chang SA
• Choi JO
• Lee SC
• Park SW
• Oh JK

• KMID: 2177313
• DOI: http://doi.org/10.4250/jcu.2010.18.4.127

Abstract

BACKGROUND
Although there were studies about ethnic differences in aortic valve thickness and calcification that they may play a role in aortic valvular stenosis (AVS) progression, few studies about the progression rate of AVS in Asian population have been reported. The purpose of this study was to evaluate the progression rate of AVS in Korean patients.
METHODS
We retrospectively analyzed 325 patients (181 men, age: 67 +/- 13 years) with AVS who had 2 or more echocardiograms at least 6 months apart from 2003 to 2008. The patients with other significant valvular diseases or history of cardiac surgery were excluded. The progression rate of AVS was expressed in terms of increase in maximum aortic jet velocity per year (meter/second/year).
RESULTS
Baseline AVS was mild in 207 (64%), moderate in 81 (25%), and severe in 37 (11%). There were no significant differences among the three groups in terms of age, gender, hypertension, smoking, and hypercholesterolemia. The mean progression rate was 0.12 +/- 0.23 m/s/yr and more rapid in severe AVS (0.28 +/- 0.36 m/s/yr) when compared to moderate (0.14 +/- 0.26 m/s/yr) and mild AVS (0.09 +/- 0.18 m/s/yr) (p < 0.001). The progression rate in bicuspid AVS was significantly higher than other AVS (0.23 +/- 0.35 vs. 0.11 +/- 0.20 m/s/yr, p = 0.002). By multivariate analysis, initial maximum aortic jet velocity (Beta = 0.175, p = 0.003), bicuspid aortic valve (Beta = 0.127, p = 0.029), and E velocity (Beta = -0.134, p = 0.018) were significantly associated with AVS progression.
CONCLUSION
The progression rate of AVS in Korean patients is slower than that reported in Western population. Therefore, ethnic difference should be considered for the follow-up of the patients with AVS.

Keyword

Aortic valvular stenosis; Natural history; Disease progression

MeSH Terms

Aortic Valve
Aortic Valve Stenosis
Asian Continental Ancestry Group
Bicuspid
Constriction, Pathologic
Disease Progression
Follow-Up Studies
Heart Valve Diseases
Humans
Hypercholesterolemia
Hypertension
Male
Multivariate Analysis
Natural History
Retrospective Studies
Smoke
Smoking
Thoracic Surgery
Aortic Valve
Heart Valve Diseases
Smoke

Figure

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  Fig. 1 Progression rate of maximum aortic jet velocity according to AVS severity. Bars, mean ± SD. A p value indicates difference between groups based on scheffe's multiple comparison test. AVS: aortic valvular stenosis.

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  Fig. 2 Progression rate of maximum aortic jet velocity with and without bicuspid aortic valve. Bars, mean ± SD. AVS: aortic valvular stenosis.

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