Article Text

other Versions

PDF
Original article
The evolving epidemiology of valvular aortic stenosis. The Tromsø Study
  1. Gry Wisthus Eveborn1,2,
  2. Henrik Schirmer1,2,
  3. Geir Heggelund1,
  4. Per Lunde1,
  5. Knut Rasmussen2
  1. 1Department of Heart Disease, Division of Cardiothoracic and Respiratory Medicine, University Hospital of Northern Norway, Tromsø, Norway
  2. 2Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
  1. Correspondence to Dr Gry Wisthus Eveborn, From the Department of Heart Disease, Division of Cardiothoracic and Respiratory Medicine, University Hospital of Northern Norway, Tromsø 9038, Norway; gry.eveborn{at}unn.no

Abstract

Objective To assess prevalence, incidence, prognosis and progression of degenerative valvular aortic stenosis (AS).

Setting The Tromsø Study and the University Hospital of North Norway.

Design Population based prospective study.

Population Over a 14 year span we performed three repeated echocardiographic examinations (1994, 2001 and 2008) of a random sample of initially 3273 participants. Data from the only hospital serving this population were included.

Results There were 164 subjects with AS. Prevalence consistently increased with age, average values being 0.2% in the 50–59 year cohort, 1.3% in the 60–69 year cohort, 3.9% in the 70–79 year cohort and 9.8% in the 80–89 year cohort. The incidence rate in the study was 4.9‰/year. The mean annual increase in mean transvalvular pressure gradient was 3.2 mm Hg. The increase was lower in mild AS than in more severe disease, disclosing a non-linear development of the gradient, but with large individual variations. Mortality was not significantly increased in the asymptomatic AS-group (HR=1.28), nor in those who received aortic valve replacement (n=34, HR=0.93), compared with the general population.

Conclusion This is the first study to document the incidence and prognosis of AS in a general population with surgery as a treatment option. It reveals an accelerated progression of the aortic mean gradient as the disease advances. The prognosis of AS seems to be comparable with the normal population in the asymptomatic stage and after successful surgery, indicating that the follow-up and timing of surgery has been adequate for this patient group.

  • Aortic valve disease
  • epidemiology
  • echocardiography
  • public health
  • cardiac function
  • cardiac remodelling
  • diastolic dysfunction
  • haemodynamics
  • systolic dysfunction

Statistics from Altmetric.com

Footnotes

  • Funding This study was supported by the Northern Norway Regional Health Authorities (PhD grant number SFP-727-08).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by The Regional Committee for Medical and Health Research Ethics, Northern Norway. rek-nord{at}fagmed.uit.no

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.