Aortic Stenosis Progression Risk Calculator

1
Patient Parameters

Demographics & Vitals

Age

years

BMI

kg/m²

Systolic BP

mmHg

Labs & Hemodynamics

Baseline Mean Gradient

mmHg

eGFR

mL/min/1.73

LDL Cholesterol

mg/dL

Advanced Echo (Optional)

LV Mass Index

g/m²

Stroke Volume Index

mL/m²

Clinical History

Atrial Fibrillation

Diabetes

Current Smoker

Awaiting Calculation

Enter patient parameters and click calculate to view the estimated progression risk.

Estimated Progression

0.000 cm²/yr

Risk Category

Clinical Interpretation

Recommended Action

Modifiable Risk Targets

AI Clinical Assistant

Gemini API Key (Required for AI features)

Your key is used locally in your browser and is never stored.

Reference Materials

Aortic Valve Area (AVA) Reference Guidelines

Standard classification of aortic stenosis severity (at rest, per AHA/ACC 2020 & ESC 2021 Guidelines).

Severity Grade	AVA (cm²)	Mean Grad. (mmHg)	Peak Vel. (m/s)
Normal	> 2.0	< 10	< 2.0
Mild AS	1.5 – 2.0	< 20	< 3.0
Moderate AS	1.0 – 1.5	20 – 40	3.0 – 4.0
Severe AS	≤ 1.0	≥ 40	≥ 4.0
Very Severe AS	≤ 0.6	≥ 60	≥ 5.0

Underlying Algorithm & Weights

The estimated annual AVA decline (cm²/year lost) is calculated as a positive value:

annual_decline = 0.0013 × age + (if mean gradient > 20: 0.001 × (mean gradient - 20)) + (if eGFR < 60: 0.059) + (0.021 × atrial fibrillation [0 or 1]) + (0.020 × diabetes [0 or 1]) + (if SBP > 140: 0.020) + (if BMI > 30: 0.020) + (0.020 × smoking [0 or 1]) + (if LDL > 100: 0.020) + (0.00038 × LVMI [if provided]) + (0.0008 × SVI [if provided])

Higher calculated value = faster progression.
Primary coefficients derived from the 2024 Venema multivariable model.
Modifiable factor weights (~0.020) are heuristic approximations derived from hazard ratios in supporting literature.

Supporting Literature

Venema CS, et al. Prediction of the Individual Aortic Stenosis Progression Rate and its Association With Clinical Outcomes. JACC: Advances. 2024.
Median AVA decrease: 0.09 cm²/y (IQR: 0.04-0.15 cm²/y); rapid progressors: 0.15 cm²/y vs. slow: 0.04 cm²/y. Multivariable model: Older age (0.013 cm²/y per 10 years), AF (0.021 cm²/y), CKD (0.059 cm²/y), higher LVMI (0.019 cm²/y per 50 g/m²), higher SVI (0.008 cm²/y per 10 mL/m²).
Capoulade R, et al. Aortic Stenosis Progression: A Systematic Review and Meta-Analysis. JACC: Cardiovascular Imaging. 2023.
Pooled AVA decline: 0.08 cm²/year (95% CI: 0.06-0.10). Faster in severe baseline AS (0.09 cm²/year) vs. mild (0.07 cm²/year).
Yan AT, et al. Association Between Cardiovascular Risk Factors and Aortic Stenosis. JACC. 2017.
Hypertension: aHR 1.71, PAR 23.4%. Diabetes: aHR 1.49, PAR 5.6%. Dyslipidemia: aHR 1.17, PAR 4.4%. Combined PAR 34.4%.
Ko T-Y, et al. Incidence, risk factors and predictors of cardiovascular mortality for aortic stenosis among patients with diabetes mellitus. Diabetes Research and Clinical Practice. 2022.
In T2DM patients, AS incidence: 3.02 cases/1000 person-years. Risk factors include AF (aHR 1.69), statin protective (aHR 0.78).

1 Patient Parameters