Aortic valve sclerosis and aortic atherosclerosis: different manifestations of the same disease? Insights from a population-based study.
OBJECTIVE
The aim of this study was to examine the association between atherosclerosis risk factors, aortic atherosclerosis and aortic valve abnormalities in the general population.


BACKGROUND
Clinical and experimental studies suggest that aortic valve sclerosis (AVS) is a manifestation of the atherosclerotic process.


METHODS
Three hundred eighty-one subjects, a sample of the Olmsted County (Minnesota) population, were examined by transthoracic and transesophageal echocardiography. The presence of AVS (thickened valve leaflets), elevated transaortic flow velocities and aortic regurgitation (AR) was determined. The associations between atherosclerosis risk factors, aortic atherosclerosis (imaged by transesophageal echocardiography) and aortic valve abnormalities were examined.


RESULTS
Age, male gender, body mass index (odds ratio [OR]: 1.07 per kg/m(2); 95% confidence interval [CI]: 1.02 to 1.12), antihypertensive treatment (OR: 1.93; CI: 1.12 to 3.32) and plasma homocysteine levels (OR: 1.89 per twofold increase; CI: 0.99 to 3.61) were independently associated with an increased risk of AVS. Age, body mass index and pulse pressure (OR: 1.21 per 10 mm Hg; CI: 1.00 to 1.46) were associated with elevated (upper quintile) transaortic velocities, whereas only age was independently associated with AR. Sinotubular junction sclerosis (p = 0.001) and atherosclerosis of the ascending aorta (p = 0.03) were independently associated with AVS and elevated transaortic velocities, respectively.


CONCLUSIONS
Atherosclerosis risk factors and proximal aortic atherosclerosis are independently associated with aortic valve abnormalities in the general population. These observations suggest that AVS is an atherosclerosis-like process involving the aortic valve.
Agmon
Y
Y
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Khandheria
B K
BK
Meissner
I
I
Sicks
J R
JR
O'Fallon
W M
WM
Wiebers
D O
DO
Whisnant
J P
JP
Seward
J B
JB
Tajik
A J
AJ
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000453:epidemiology / Q000473:pathology*; D001021:Aortic Valve / Q000473:pathology*; D001161:Arteriosclerosis / Q000453:epidemiology / Q000473:pathology*; D009202:Cardiomyopathies / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors