Rapid annual progression of mean gradient > 2 mm/year in AS patients was related to raphe [OR:8.3(CI:1.12–61.55); p = 0.04], diabetes [OR: 2.6 (CI:1.25–5.46); p = 0.01], dyslipidemia [OR:1.8 (CI:1.11–2.95); p = 0.18], BAV-LN [OR:9.3 (CI:2.28–38.06); p = 0.02] and basal mean gradient [OR: 1.1 (CI: 1.08–1.13); p < 0.0001]. The gene discussed is MLPH; the disease is metabolic syndrome.