{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:40:14Z","timestamp":1783395614139,"version":"3.54.6"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,20]]},"abstract":"\n Background<\/jats:title>\n \n American Heart Association and American College of Cardiology guidelines articulate 4 aortic stenosis (\n AS<\/jats:styled-content>\n ) stages to highlight its progressive nature, but limited data exist on cardiac alterations in sub\u2010severe stages.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n ARIC (Atherosclerosis Risk in Communities) study participants with protocol echocardiography at Visit 5 (\n V5<\/jats:styled-content>\n ; 2011\u20132013) and free of aortic valve (\n AV<\/jats:styled-content>\n ) replacement or cardiovascular disease were classified by\n ACC<\/jats:styled-content>\n \/\n AHA AS<\/jats:styled-content>\n stages at\n V5<\/jats:styled-content>\n and Visit 7 (\n V7<\/jats:styled-content>\n ; 2018\u20132019).\n AS<\/jats:styled-content>\n stage progression was defined as\n AV<\/jats:styled-content>\n replacement or hospitalization, or a higher stage at\n V7<\/jats:styled-content>\n . Associations of\n AS<\/jats:styled-content>\n stage at\n V5<\/jats:styled-content>\n and\n AS<\/jats:styled-content>\n stage progression from\n V5<\/jats:styled-content>\n to\n V7<\/jats:styled-content>\n with cardiac structure and function were assessed using multivariable linear regression. Associations of extra\u2010\n AV<\/jats:styled-content>\n cardiac abnormality categories with\n AS<\/jats:styled-content>\n stage progression were assessed by multivariable logistic regression.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 5206\n V5<\/jats:styled-content>\n participants (age 75\u00b15\u2009years, 40% men),\n AS<\/jats:styled-content>\n stages A and B at\n V5<\/jats:styled-content>\n were associated with greater left ventricular wall thickness, mass, and filling pressure measures at both\n V5<\/jats:styled-content>\n and\n V7<\/jats:styled-content>\n compared with Stage 0. Among 1562 participants with assessable\n AS<\/jats:styled-content>\n stage at\n V7<\/jats:styled-content>\n ,\n AS<\/jats:styled-content>\n stage progression occurred in 370 and was associated with greater worsening of these measures (all\n P<\/jats:italic>\n <0.02). The presence of both left ventricular and left atrial extra\u2010\n AV<\/jats:styled-content>\n abnormalities was associated with greater likelihood of\n AS<\/jats:styled-content>\n stage progression (\n odds ratio<\/jats:styled-content>\n 1.7 [95%\n CI,<\/jats:styled-content>\n 1.2\u20132.6],\n P<\/jats:italic>\n =0.009).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Early\n AS<\/jats:styled-content>\n stages are associated with greater left ventricular mass and diastolic dysfunction, and\n AS<\/jats:styled-content>\n stage progression is associated with worsening of these measures. The presence of both left ventricular and\n left atrial<\/jats:styled-content>\n extra\u2010\n AV<\/jats:styled-content>\n abnormalities is associated with a greater likelihood of early\n AS<\/jats:styled-content>\n stage progression.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.125.045047","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T11:42:28Z","timestamp":1768390948000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Alterations in Cardiac Structure and Function Associated With Sub\u2010Severe Aortic Stenosis Progression: The ARIC Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6233-8013","authenticated-orcid":false,"given":"Khaled","family":"Shelbaya","sequence":"first","affiliation":[{"name":"University of Texas Southwestern Medical Center","place":["Dallas, 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