Work

Progression rates of aortic stenosis in patients with calcific and rheumatic heart disease in Saudi Arabia

Year: 2026

Type: article

Abstract: Study objective Calcific aortic stenosis (AS) is the most prevalent type of AS in developed countries. However, in developing countries, rheumatic heart disease (RHD), which has a low progression rate, remains the prevalent type. This study compared the progression rates of AS between the National Guard cohort and Western populations. Design This was a retrospective single-center cohort study. Participants Involving patients who underwent two echocardiographic examinations within an interval of at least 2 years. Main outcome measures Progression of aortic valve stenosis was assessed by measuring changes in the aortic valve area (AVA), peak aortic velocity, and mean aortic valve gradient. Results In total, 1669 patients (median follow-up: 6.9 years) were included in the analysis. The overall annual AVA progression rate was 0.074 ± 0.1 cm 2 /year (median: −0.061 cm 2 /year). Patients with RHD had lower progression rates than those without RHD (25%–35%; AVA: −0.036 [−0.042, −0.030] cm 2 /year). Patients with end-stage renal disease (ESRD) who exhibited calcific AS had the highest progression rate (AVA: −0.102 ± 0.096 cm 2 /year). The overall progression rate of AS for the National Guard cohort was lower across all groups compared with that in Western populations (AVA: −0.08 to 0.12 cm 2 /year). Conclusions Patients with ESRD who had calcific AS had the highest progression rate. Meanwhile, patients with RHD exhibited the lowest progression rate. The high prevalence of calcific AS in our study shows the importance of adherence to the American College of Cardiology/European Society of Cardiology guidelines for disease management.

Source: American Heart Journal Plus Cardiology Research and Practice

DOI: 10.1016/j.ahjo.2026.100976