What question did this study set out to answer?

This research aims to define the natural progression of aortic valve sclerosis to aortic stenosis.

January 18, 2026Open Access

Prognostic significance implications of aortic valve sclerosis in the development of aortic stenosis: a systematic review and meta-analysis

Resultado clave

14.1% of patients with aortic valve sclerosis progressed to any stage of aortic stenosis over 4 years, while 2.0% progressed to severe aortic stenosis.

Puntos clave

This research aims to define the natural progression of aortic valve sclerosis to aortic stenosis.
Conducted a systematic review following PRISMA guidelines.
Searched databases like PubMed and Scopus for observational studies.
Calculated pooled event rates and explored heterogeneity using statistical methods.
Performed meta-regression to find associations with clinical and demographic variables.
14.1% of patients with aortic valve sclerosis progressed to any stage of aortic stenosis over 4 years.
2.0% progressed to severe aortic stenosis during the same period.
High heterogeneity was noted in the progression rates, but no publication bias was found.

PICO estructurado

Población

24,376 patients with fibrocalcific aortic valve sclerosis (AVSc) pooled from observational studies. For progression to any degree of AS (8 studies, n=12,388): median age 72, 61% male. For progression to severe AS (9 studies, n=19,486): median age 71, 67% male.

Resultado

Progression to any degree of aortic stenosis (mild, moderate or severe) and progression to severe aortic stenosis alone during follow-upsurrogate

Approximately 14% of patients with aortic valve sclerosis progress to any degree of aortic stenosis and 2% to severe aortic stenosis within 4 years, underscoring the importance of structured echocardiographic surveillance.

Resultado numérico

Tasa de eventos absoluta: 0% vs 0%

Resumen

Background Fibrocalcific aortic valve sclerosis (AVSc), the earliest manifestation of aortic stenosis (AS), is increasingly recognised as a marker of systemic vascular damage and adverse cardiovascular outcomes. While a subset of AVSc patients progresses to AS, reported rates vary widely. We conducted a systematic review and meta-analysis to better define the natural history of AVSc progression. Methods Following Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, we searched PubMed, Scopus and Web of Science through July 2025 for observational studies reporting AS development in AVSc patients. Primary outcomes were progression to any degree of AS and to severe AS. Pooled event rates were calculated using a random-effects model. Heterogeneity and publication bias were assessed using standard statistical methods. Meta-regression explored associations with clinical and demographic variables. Results Eight studies (n=12 388 patients) reported on the progression of AVSc patients to any AS stage, and nine studies (n=19 486 patients) on the progression to severe AS. Over a median follow-up of 4.0 years, 14.1% of AVSc patients progressed to any AS stage (effect size: 0.14; 95% CI 0.02 to 0.53), and 2.0% to severe AS (effect size: 0.02; 95% CI 0.003 to 0.094). Heterogeneity was high, but no publication bias was detected. Meta-regression found no significant predictors of progression. Conclusions Approximately one in six AVSc patients progresses to AS within 4 years, and 2% develop a severe disease. These findings underscore the importance of structured echocardiographic surveillance and support AVSc as a clinically relevant marker of systemic cardiovascular risk.

Me gusta

Guardar

Ver artículo completo