Clinical determinants and outcomes of aortic stenosis progression in an Asian cohort

Abstract Background Aortic stenosis (AS) is the most prevalent valvulopathy globally. There remains a knowledge gap on clinical determinants of AS progression in Asian patients. Insights into this may confer prognostic benefits. Methods 101 patients with index diagnoses of aortic stenosis and paired echocardiograms 2 years apart were enrolled between 2011-2021. Patients were stratified into 2 groups - the first were AS progressors, defined by progression to severe AS: aortic valve area (AVA)40mmHg, peak jet velocity (Vmax)>4 m/s, from moderate AS: AVA 1.0-1.5cm², Vmax 3-4m/s, MPG 20-40mmHg. The second group was AS non-progressors who did not meet progression criteria. Demographics, co-morbidities, echocardiographic parameters and clinical outcomes were compared. Results AS progression was associated with higher proportions of smoking, hypertension, hyperlipidaemia, diabetes and coronary artery disease. The mean rate of AVA change/year was 0.7+0.8cm² in progressors vs. 0.1+0.3cm² in non-progressors (p