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John E. Cosmi, MD; Smadar Kort, MD; Paul A. Tunick, MD; Barry P. Rosenzweig, MD; Robin S. Freedberg, MD; Edward S. Katz, MD; Robert M. Applebaum, MD; Itzhak Kronzon, MD

Arch Intern Med. 2002;162:2345-2347.

Background  Aortic valve thickening (AVT) without aortic stenosis (AS) is common and was often considered benign. However, it has recently been found to be associated with increased morbidity and mortality. It is unknown whether patients with AVT are at risk for the development of AS.

Methods  Our echocardiography database from 1987 to 1993 was searched for cases of AVT with at least 1 year of echocardiographic follow-up. The risk of the development of AS was compared in patients with and without AVT.

Results  There were 2131 patients with AVT and at least 1 year of echocardiographic follow-up. Aortic stenosis developed in 338 patients (15.9%) (mild, 10.5%; moderate, 2.9%; and severe, 2.5%). Multivariate analysis, including age, left ventricular hypertrophy, and mitral annular calcification, revealed that only mitral annular calcification was independently and significantly associated with progression to AS.

Conclusions  Aortic valve thickening without stenosis is common, and it may progress to significant AS. It is possible that this development of AS may be responsible for some of the increased morbidity and mortality in patients with AVT.

From the Noninvasive Cardiology Laboratory, Department of Medicine, New York University School of Medicine, New York, NY.

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