Echocardiogram re-screening of older adults at a mean of 8.5 years revealed that 65.3% had some degree of valvular heart disease, with 12.6% having clinically significant disease.
Cohort (n=1,692)
In older adults without known valvular heart disease at baseline, echocardiographic screening reveals that over 65% develop some degree of VHD over 8.5 years, with 12.6% having clinically significant disease.
Abstract Background Valvular heart disease (VHD) is common but progression of VHD is unpredictable and there is uncertainty regarding optimum monitoring or risk factors for advanced disease. OxVALVE is the largest prospective epidemiological study of VHD worldwide. Between 2009-2016, 4,009 people aged 65 years without established VHD attended initial echocardiogram screening. All of the original cohort who remained alive and were fit to attend were invited to re-screening (2016-2025). Purpose To report on the prevalence, incidence and progression of VHD among OxVALVE participants at rescreening. Methods The initial and rescreen echocardiograms were compared. VHD was defined as stenosis or regurgitation of any valve. Severity of VHD was categorised as none/trivial, mild, or clinically significant (≥moderate). Calcific valve abnormalities that do not have a functional effect were considered separately, including aortic sclerosis. Results Of the original participants, 1,692 (42.2%) were alive and agreed to attend re-screening. The mean time between the baseline and follow-up echocardiograms was 8.5 years (SD 1.24). The mean age at re-screening was 78.5 years (SD 2.12) and 52.2% were female. Among these participants, at the initial visit 45 people (2.7%) had clinically significant and 739 (44.8%) mild VHD of at least one valve. This increased at re-screening to 214 participants (12.6%) with clinically significant and 894 (52.7%) with mild VHD. The most frequent categories of VHD at rescreen were tricuspid regurgitation (TR) (n=750, 44.3%), followed by mitral regurgitation (MR) (n=716, 42.3%) and 1,198 (70.8%) also had aortic sclerosis. TR was the most common incident VHD; 385 (31.8%) people developed mild TR and 37 (3.1%) clinically significant having had none/trivial TR at initial screen. MR was second most common incident VHD with corresponding figures of 336 (26.6%) and 27 (2.1%). Progression from mild to significant VHD was also most common for TR (n=75, 16.6%), followed by MR (n=48, 11.9%), though 8 of the 11 (72.7%) people with initial mild aortic stenosis (AS) progressed to clinically significant AS. Only 15 (0.8%) participants had aortic stenosis (AS) at baseline, though known VHD was a study exclusion criteria. At rescreen, 56 (3.3%) people had AS, which was clinically significant for 24 (1.4%). A further 9 (0.5%) had undergone aortic valve replacement, including all those with initially clinically significant AS. Excluding these, 29 people had incident mild (1.7%) and 17 (1.0%) incident clinically significant AS. Conclusion In this large, longitudinal population re-screening study, some degree of VHD was present among 65.3% of participants by follow-up (mean age 78 years) and more than one in ten had clinically significant VHD. Non-functional valvular changes were extremely common and over 70% had aortic sclerosis. Progression of TR and MR was most common. Further work will explore risk factors for progressive VHD and survival in the cohort.VHD severity at initial screen & rescan VHD incidence, progression & prevalence
Jones et al. (2025) conducted a cohort in Valvular heart disease (n=1,692). Echocardiogram screening was evaluated on Prevalence, incidence and progression of VHD. Echocardiogram re-screening of older adults at a mean of 8.5 years revealed that 65.3% had some degree of valvular heart disease, with 12.6% having clinically significant disease.