{"id":"cb00229badff","type":"article","url":"https://hartvaat.nl/2026/01/16/aortaklepsclerose-ongeveer-een-op-de-zeven-gaat-binnen-vier-jaar-over-in-aortast/","title":"Aortaklepsclerose: ongeveer één op de zeven gaat binnen vier jaar over in aortastenose","title_en":"Prognostic implications of aortic valve sclerosis in the development of aortic stenosis: a systematic review and meta-analysis","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts"],"tags":["acuut-hartfalen","aortacoarctatie","aortainsufficiëntie","aortastenose","atherosclerose"],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e003859?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003859?rss=1","authors":["Myasoedova","V. A.","Valerio","V.","Massaiu","I.","Bertolini","F.","Rusconi","V.","Marenzi","G.","Poggio","P."],"significance":5,"published":"2026-01-16","source_date":"2026-01-16","image":"","kennis":["https://hartvaat.nl/kennis/kleplijden/aortastenose/","https://hartvaat.nl/kennis/kleplijden/tavi-transcatheter-aortaklepimplantatie/"],"congress":"","summary_en":"Fibrocalcific aortic valve sclerosis (AVSc) is the earliest form of aortic stenosis (AS) and is increasingly seen as a marker of systemic vascular damage and cardiovascular risk. Reported progression to AS varies widely. This systematic review and meta-analysis (8 studies, 12,388 patients for progression to any AS; 9 studies, 19,486 for severe AS) mapped the natural history. Over a median four-year follow-up, 14.1% of AVSc patients progressed to any form of AS and 2.0% to severe AS. Heterogeneity was high and meta-regression found no significant predictors. About one in seven patients with aortic valve sclerosis thus develops aortic stenosis within four years, and 2% a severe form — underscoring the importance of structured echocardiographic surveillance and of AVSc as a risk marker.","created":"2026-07-03T10:32:28Z","updated":"2026-07-03T13:31:25Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Fibrocalcifische aortaklepsclerose (AVSc) is de vroegste vorm van aortaklepstenose (AS) en wordt steeds meer gezien als een marker van systemische vaatschade en cardiovasculair risico. De gerapporteerde progressie naar AS varieert sterk. Deze systematische review en meta-analyse (8 studies, 12.388 patiënten voor progressie naar enige AS; 9 studies, 19.486 patiënten voor ernstige AS) bracht het natuurlijke beloop in kaart. Over een mediane follow-up van vier jaar ging 14,1% van de AVSc-patiënten over in enige vorm van AS en 2,0% in ernstige AS. De heterogeniteit was hoog en meta-regressie vond geen significante voorspellers. Ongeveer één op de zeven patiënten met aortaklepsclerose ontwikkelt dus binnen vier jaar aortastenose, en 2% een ernstige vorm — wat het belang van gestructureerde echocardiografische controle en van AVSc als risicomarker onderstreept.","abstract_original":"Background\n

Fibrocalcific aortic valve sclerosis (AVSc), the earliest manifestation of aortic stenosis (AS), is increasingly recognised as a marker of systemic vascular damage and adverse cardiovascular outcomes. While a subset of AVSc patients progresses to AS, reported rates vary widely. We conducted a systematic review and meta-analysis to better define the natural history of AVSc progression.

\n\nMethods\n

Following Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, we searched PubMed, Scopus and Web of Science through July 2025 for observational studies reporting AS development in AVSc patients. Primary outcomes were progression to any degree of AS and to severe AS. Pooled event rates were calculated using a random-effects model. Heterogeneity and publication bias were assessed using standard statistical methods. Meta-regression explored associations with clinical and demographic variables.

\n\nResults\n

Eight studies (n=12 388 patients) reported on the progression of AVSc patients to any AS stage, and nine studies (n=19 486 patients) on the progression to severe AS. Over a median follow-up of 4.0 years, 14.1% of AVSc patients progressed to any AS stage (effect size: 0.14; 95% CI 0.02 to 0.53), and 2.0% to severe AS (effect size: 0.02; 95% CI 0.003 to 0.094). Heterogeneity was high, but no publication bias was detected. Meta-regression found no significant predictors of progression.

\n\nConclusions\n

Approximately one in six AVSc patients progresses to AS within 4 years, and 2% develop a severe disease. These findings underscore the importance of structured echocardiographic surveillance and support AVSc as a clinically relevant marker of systemic cardiovascular risk.

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