Over the past few years, important publications have addressed the issue of longitudinal assessment of valvular heart disease. The American College of Cardiology and the American Heart Association jointly published guidelines on echocardiography. Aortic stenosis continues to be well studied, with papers characterizing the rates of progression of mean and peak gradients, as well as aortic valve area changes. Doppler assessment of the progression of aortic regurgitation has been shown in larger studies than have been performed in the past. Based on an important study in patients with chronic aortic regurgitation, the optimal timing of surgery in asymptomatic mild to moderate aortic regurgitation may be predicted by indices of left ventricular function and left ventricular stress. Finally, mitral stenosis and mitral regurgitation studies evaluated rates of progression and also optimal timing for surgery.