Progression Rate of Aortic Valve Stenosis in Korean Patients

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 ${\pm}$ 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 ${\pm}$ 0.23 m/s/yr and more rapid in severe AVS (0.28 ${\pm}$ 0.36 m/s/yr) when compared to moderate (0.14 ${\pm}$ 0.26 m/s/yr) and mild AVS (0.09 ${\pm}$ 0.18 m/s/yr) (p < 0.001). The progression rate in bicuspid AVS was significantly higher than other AVS (0.23 ${\pm}$ 0.35 vs. 0.11 ${\pm}$ 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.