Their mean age was 67 ± 13 years. The mean value of initial maximum aortic jet velocity in total patients was 2.92 ± 0.81 m/s. The AVS was mild in 207 of 326 patients (63%), moderate in 81 (25%), and severe in 37 (12%). One hundred ninety three patients (59%) had hypertension, 93 (29%) were dia-betics, 53 (17%) were current smokers, and 144 (45%) had hypercholesterolemia. There were no significant differences among the three groups in terms of age, gender, hypertension, smoking, and hypercholesterolemia. The LVMI Inhibitors,research,lifescience,medical was larger in severe AVS (125.4 ± 34.5 g/m2) compared to moderate (121.7 ± 34.1 g/m2) and mild (111.6 ± 32.3 g/m2) (p = 0.013). BAV was present in 41 (13%) and more frequent

in severe AVS than in moderate Inhibitors,research,lifescience,medical and mild AVS (32% vs. 19% vs. 7%, p < 0.001). Table 1 and ​and22 show initial clinical and echocardiographic

characteristics in each group, respectively. Table 1 Clinical characteristics Table 2 Echocardiographic parameters Progression rate of aortic valvular stenosis The mean interval of the echocardiographic studies was 28 ± 13 months. Over this period of time, the maximum aortic jet velocity increased from 2.92 Inhibitors,research,lifescience,medical ± 0.81 to 3.19 ± 0.99 m/s and the annual progression rate of maximum aortic jet velocity was 0.12 ± 0.23 m/s/yr, indicating a wide variability in AVS progression. The annual progression rate was more rapid in severe AVS (0.28 ± 0.36 m/s/yr) compared to moderate (0.14 ± 0.25 m/s/yr) and mild AVS (0.09 ± 0.18 m/s/yr) (p < 0.001) (Fig.

1). The progression rate in bicuspid AVS was significantly higher Inhibitors,research,lifescience,medical than that of tricuspid AVS (0.23 ± 0.35 vs. 0.11 ± 0.20 m/s/yr, p = 0.001) (Fig. 2). Fig. 1 Progression rate of maximum aortic jet velocity according to AVS severity. Bars, mean ± SD. A p value indicates difference between groups based on scheffe’s multiple comparison test. AVS: aortic valvular stenosis. Fig. 2 Progression rate of maximum aortic jet velocity with and without bicuspid aortic Inhibitors,research,lifescience,medical valve. Bars, mean ± SD. AVS: aortic valvular stenosis. Comparison of rapid and slow Cell Cycle inhibitor progressors At a mean increase in maximum aortic jet velocity per year of 0.12 m/s, the patients were dichotomously divided into rapid (≥ 0.12 m/s/yr) and slow progressors (< 0.12 m/s/yr). As shown Thiamine-diphosphate kinase in Table 3, the rapid progressor had higher initial maximum aortic jet velocity (p = 0.002), higher mean transvalvular gradient (p < 0.001), smaller AVA (p = 0.007), and lower E velocity (p = 0.018). Table 3 Comparison of rapid versus slow progressors of aortic valvular stenosis Multiple regression analysis for factors associated with AVS progression A stepwise multiple regression analysis was carried out to identify the factors which were associated with the increase in maximum aortic jet velocity per year. In univariate analysis, the progression rate of AVS was significantly related to BAV, creatinine, initial maximum aortic jet velocity, LV end-diastolic dimension, left atrial dimension, and E velocity.