Diabetes Is Associated With Rapid Progression of Aortic Stenosis: A Single-Center Retrospective Cohort Study

Kangning Han; Dongmei Shi; Lixia Yang; Meng Xie; Rongrong Zhong; Zhijian Wang; Fei Gao; Xiaoteng Ma; Yujie Zhou

doi:10.3389/fcvm.2021.812692

Diabetes Is Associated With Rapid Progression of Aortic Stenosis: A Single-Center Retrospective Cohort Study

Front Cardiovasc Med. 2022 Feb 23:8:812692. doi: 10.3389/fcvm.2021.812692. eCollection 2021.

Authors

Kangning Han^{1

2

3}, Dongmei Shi^{1

2

3}, Lixia Yang^{1

2

3}, Meng Xie⁴, Rongrong Zhong⁵, Zhijian Wang^{1

2

3}, Fei Gao^{1

2

3}, Xiaoteng Ma^{1

2

3}, Yujie Zhou^{1

2

3}

Affiliations

¹ Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
² Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China.
³ The Key Laboratory of Remodeling-Related Cardiovascular Disease, Ministry of Education, Beijing, China.
⁴ Department of Echocardiogram, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
⁵ Faculty of Medicine, Imperial College London, London, United Kingdom.

Abstract

Background: Mounting evidence indicates that rapid progression of aortic stenosis (AS) is significantly associated with poor prognosis. Whether diabetes accelerates the progression of AS remains controversial.

Objectives: The purpose of the present study was to investigate whether diabetes was associated with rapid progression of AS.

Methods: We retrospectively analyzed 276 AS patients who underwent transthoracic echocardiography at least twice with a maximum interval ≥ 180 days from January 2016 to June 2021. AS severity was defined by specific threshold values for peak aortic jet velocity (V_max) and/or mean pressure gradient. An increase of V_max ≥ 0.3 m/s/year was defined as rapid progression. The binary Logistic regression models were used to determine the association between diabetes and rapid progression of AS.

Results: At a median echocardiographic follow-up interval of 614 days, the annual increase of V_max was 0.16 (0.00-0.41) m/s. Compared with those without rapid progression, patients with rapid progression were older and more likely to have diabetes (P = 0.040 and P = 0.010, respectively). In the univariate binary Logistic regression analysis, diabetes was associated with rapid progression of AS (OR = 2.02, P = 0.011). This association remained significant in the multivariate analysis based on model 2 and model 3 (OR = 1.93, P = 0.018; OR = 1.93, P = 0.022). After propensity score-matching according to V_max, diabetes was also associated rapid progression of AS (OR = 2.57, P = 0.045).

Conclusions: Diabetes was strongly and independently associated with rapid progression of AS.

Keywords: aortic stenosis; diabetes; rapid progression; transthoracic echocardiography; valvular disease.