Authors

• Katica Cvitkušić Lukenda — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0001-6188-0708
• Marijana Knežević Praveček — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-8727-7357
• Krešimir Gabaldo — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia — ORCID: 0000-0002-0116-5929
• Blaženka Miškić — General Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia

Keywords

valvular calcification, inflammation, gastric inhibitory polypeptide and glucagon-like peptide-1 receptor agonists

DOI

Full Text

Aortic stenosis (AS) is the most common valvular heart disease in the elderly, associated with high morbidity and mortality. Its pathophysiology involves inflammation, fibrosis, and calcification of the aortic valve. At the same time, the global prevalence of obesity continues to rise at an alarming rate, becoming one of the most significant public health concerns. Recently, obesity has emerged as an important risk factor influencing AS development. Obesity affects hemodynamics, promotes systemic inflammation, and alters metabolism, potentially accelerating the progression of valvular degeneration. Epidemiological studies, including the Cohort of Swedish Men and the Swedish Mammography Cohort, have shown a significant association between body mass index (BMI), waist circumference (WC), and the risk of clinically significant AS (1). According to a study by Kontogeorgos et al, (2) women with overweight or obesity have an increased likelihood of being diagnosed with aortic stenosis, with elevated risk observed even in those with high-normal BMI values. Recently published data from the Copenhagen General Population Study indicated an association between genetically determined obesity and the risk of developing symptomatic aortic stenosis and the need for intervention, independent of traditional cardiovascular risk factors (3). However, obesity remains a long-term risk factor for cardiovascular and metabolic complications. glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP) receptor agonists, used for type 2 diabetes and obesity, may provide cardiovascular benefits, but their role in AS remains uncertain (4). More research is needed to determine their impact on AS progression and outcomes. Given the link between obesity and AS, prevention and treatment of obesity are key. Identifying obesity as a modifiable risk factor may support earlier detection and more effective management of AS risk.

Literature

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2. Kontogeorgos S, Rosengren A, Sandström TZ, Fu M, Lindgren M, Basic C, et al. Association Between Body Mass Index and Risk of Aortic Stenosis in Women in the Swedish Medical Birth Registry. J Am Heart Assoc. 2024 October 15;13(20):e034891. https://doi.org/10.1161/JAHA.123.034891
3. Kaltoft M, Langsted A, Nordestgaard BG. Obesity as a Causal Risk Factor for Aortic Valve Stenosis. J Am Coll Cardiol. 2020 January 21;75(2):163–76. https://doi.org/10.1016/j.jacc.2019.10.050
4. Moiz A, Filion KB, Tsoukas MA, Yu OH, Peters TM, Eisenberg MJ. Mechanisms of GLP-1 Receptor Agonist-Induced Weight Loss: A Review of Central and Peripheral Pathways in Appetite and Energy Regulation. Am J Med. 2025 June;138(6):934–40. https://doi.org/10.1016/j.amjmed.2025.01.021