Rate of Progression of Severity of Valvular Aortic Stenosis

Abstract

Patients (26) with valvular aortic stenosis were followed up for an average period of 9 yr after the initial evaluation when the valvular disease was considered too mild for surgical treatment. The valve area was 0.7-1.9 (mean 1.2) cm2 at the 1st study and 0.3-2.0 (mean 0.9) cm2 at the 2nd study. The mean annual decrease was .apprx. 0.1 cm2 in 10 and less in the remaining patients. Advanced age and low physical working capacity at the 1st investigation were associated with rapid progression of the severity of the stenosis, but rapid progression was not predictable. At follow-up the combination of calcifications of the valve on chest X-ray, low physical working capacity and negative/biphasic T wave in V6 after exercise was present in 100% of the severe stenoses (.ltoreq. 0.6 cm2) and in 10% of the mild (.gtoreq. 1.0 cm2). The rate of progression of valvular aortic stenosis in adults is usually slow, but moderate stenoses may become severe within a few years.