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Peer-reviewedCC BY-NC-NDJournal of the American Heart Association

Associations of Mild or Trace Valvular Abnormalities With Cardiac Remodeling in Older Adults: The ARIC Study

  • Yumin Gao1
  • Jonathan Rubin2
  • Susan Cheng3
  • Lena Mathews1
  • Ajay J. Kirtane4
  • Ron C. Hoogeveen5
  • Christie M. Ballantyne5
  • Elizabeth Selvin1
  • Martin B. Leon4
  • Josef Coresh1
  • Scott D. Solomon6
  • Amil M. Shah7
1 more authors
  • Kunihiro Matsushita1
7 affiliations
  1. 1Johns Hopkins Bloomberg School of Public Health
  2. 2Pacifica Salud
  3. 3Cedars Sinai
  4. 4Columbia University Medical Center
  5. 5Baylor College of Medicine
  6. 6Brigham and Women's Hospital
  7. 7University of Texas Southwestern Medical Center
Open at sourceDOICite

Abstract

Background The impact of mild/trace valvular abnormalities on cardiac remodeling is not well understood, despite their association with poor cardiovascular outcomes. Methods Using data from 4684 participants in the ARIC (Atherosclerosis Risk in Communities) Study (2011–2013), aged 66 to 90 years, we examined cross‐sectional associations of mild/trace valvular abnormalities (aortic stenosis, aortic regurgitation, and mitral regurgitation) with cardiac parameters using multivariable linear regression models. Cardiac parameters included cardiac structure (eg, left ventricular mass index), systolic function (eg, ejection fraction), diastolic function, and biomarkers (eg, high‐sensitivity cardiac troponin T). Results The prevalence was 4.3% for mild aortic stenosis, 10.9% for mild/trace aortic regurgitation, and 44.7% for mild/trace mitral regurgitation. Mitral regurgitation showed the most consistent associations with cardiac measures (left ventricular mass index 5.48 g/m 2 [95% CI, 4.38–6.57 g/m 2 ]; ejection fraction –1.92% [95% CI, −2.29% to −1.54%]; high‐sensitivity cardiac troponin T 0.08 log ng/L [95% CI, 0.05–0.12 log ng/L]). Aortic stenosis was associated with impaired ventricular filling (Ratio of early transmitral flow velocity to early diastolic mitral annular velocity (E/e’) lateral ratio 2.00 [95% CI, 1.48–2.53]) and elevated biomarkers (high‐sensitivity cardiac troponin T 0.17 ng/L [95% CI, 0.09–0.25 ng/L]), whereas aortic regurgitation was associated with worsened cardiac structure (left ventricular mass index 3.52 [95% CI, 1.76–5.28] g/m 2 ) and systolic dysfunction (ejection fraction −1.54% [95% CI, −2.14% to −0.94%]). A dose–response relationship was also observed between the number of total abnormalities and all cardiac parameters examined. Conclusions Mild/trace mitral regurgitation was most consistently associated with all cardiac parameters examined. Aortic stenosis was associated with elevated E/e’ lateral ratio and high‐sensitivity cardiac troponin T, whereas aortic regurgitation was associated with worsening in cardiac structure and ejection fraction. Our study supports the possibility of pathophysiological contributions of these mild/trace valvular abnormalities.

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Cite

BibTeXRIS
BibTeX
@article{gao2026associations,
  title = {{Associations of Mild or Trace Valvular Abnormalities With Cardiac Remodeling in Older Adults: The ARIC Study}},
  author = {Yumin Gao and Jonathan Rubin and Susan Cheng and Lena Mathews and Ajay J. Kirtane and Ron C. Hoogeveen and Christie M. Ballantyne and Elizabeth Selvin and Martin B. Leon and Josef Coresh and Scott D. Solomon and Amil M. Shah and Kunihiro Matsushita},
  journal = {Journal of the American Heart Association},
  year = {2026},
  month = oct,
  doi = {10.1161/jaha.126.049301},
  url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.049301},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Associations of Mild or Trace Valvular Abnormalities With Cardiac Remodeling in Older Adults: The ARIC Study
AU  - Yumin Gao
AU  - Jonathan Rubin
AU  - Susan Cheng
AU  - Lena Mathews
AU  - Ajay J. Kirtane
AU  - Ron C. Hoogeveen
AU  - Christie M. Ballantyne
AU  - Elizabeth Selvin
AU  - Martin B. Leon
AU  - Josef Coresh
AU  - Scott D. Solomon
AU  - Amil M. Shah
AU  - Kunihiro Matsushita
PY  - 2026
DA  - 2026/10/20
JO  - Journal of the American Heart Association
DO  - 10.1161/jaha.126.049301
UR  - https://www.ahajournals.org/doi/10.1161/JAHA.126.049301
AB  - Background The impact of mild/trace valvular abnormalities on cardiac remodeling is not well understood, despite their association with poor cardiovascular outcomes. Methods Using data from 4684 participants in the ARIC (Atherosclerosis Risk in Communities) Study (2011–2013), aged 66 to 90 years, we examined cross‐sectional associations of mild/trace valvular abnormalities (aortic stenosis, aortic regurgitation, and mitral regurgitation) with cardiac parameters using multivariable linear regression models. Cardiac parameters included cardiac structure (eg, left ventricular mass index), systolic function (eg, ejection fraction), diastolic function, and biomarkers (eg, high‐sensitivity cardiac troponin T). Results The prevalence was 4.3% for mild aortic stenosis, 10.9% for mild/trace aortic regurgitation, and 44.7% for mild/trace mitral regurgitation. Mitral regurgitation showed the most consistent associations with cardiac measures (left ventricular mass index 5.48 g/m 2 [95% CI, 4.38–6.57 g/m 2 ]; ejection fraction –1.92% [95% CI, −2.29% to −1.54%]; high‐sensitivity cardiac troponin T 0.08 log ng/L [95% CI, 0.05–0.12 log ng/L]). Aortic stenosis was associated with impaired ventricular filling (Ratio of early transmitral flow velocity to early diastolic mitral annular velocity (E/e’) lateral ratio 2.00 [95% CI, 1.48–2.53]) and elevated biomarkers (high‐sensitivity cardiac troponin T 0.17 ng/L [95% CI, 0.09–0.25 ng/L]), whereas aortic regurgitation was associated with worsened cardiac structure (left ventricular mass index 3.52 [95% CI, 1.76–5.28] g/m 2 ) and systolic dysfunction (ejection fraction −1.54% [95% CI, −2.14% to −0.94%]). A dose–response relationship was also observed between the number of total abnormalities and all cardiac parameters examined. Conclusions Mild/trace mitral regurgitation was most consistently associated with all cardiac parameters examined. Aortic stenosis was associated with elevated E/e’ lateral ratio and high‐sensitivity cardiac troponin T, whereas aortic regurgitation was associated with worsening in cardiac structure and ejection fraction. Our study supports the possibility of pathophysiological contributions of these mild/trace valvular abnormalities.
SN  - 2047-9980
ER  -