This week, a team of researchers quietly published in @JACCJournals one of the most profound studies of valvular heart disease in recent memory. The PREVUE-VALVE study used a decentralized, in-home echocardiography model to estimate the prevalence of valvular heart disease among U.S. adults aged 65–85. Importantly, this was not a clinic-based echo cohort; participants were recruited nationally and underwent comprehensive transthoracic echo in their homes, with studies interpreted by a core lab. That intentional design choice is critical: PREVUE-VALVE is a true prevalence study, accurately representing the true burden of valve disease in the U.S. population. The findings are striking: 8.2% of older Americans have moderate or greater valvular heart disease, and 18.4% have “clinically significant” disease when mild-to-moderate regurgitation is included. TR was the most common lesion, followed by AS, MR, AR, and MS. The burden rises sharply with age, reaching nearly 15% among adults aged 80–85. Extrapolated nationally, this means approximately 4.7 million Americans aged 65–85 currently have moderate or greater VHD, projected to increase to 6.5 million by 2060. Using the broader clinically significant definition, the number is already over 10 million and projected to approach 15 million. For structural heart programs, health systems, and policymakers, the message is clear: the valve disease burden is large, growing, and will require thoughtful planning around screening, access, and treatment capacity. Congratulations to @djc795, Michael 'Mickey' Brener MD MS, and all co-authors for a stunning glimpse into the present and future of valve disease! jacc.org/doi/epdf/10.1016/j.…