Aortic valve sclerosis is associated with systemic endothelial dysfunction.
OBJECTIVE
We sought to examine the association between aortic valve sclerosis (AVS) and systemic endothelial manifestations of the atherosclerotic process.


BACKGROUND
Clinical and experimental studies suggest that AVS is a manifestation of the atherosclerotic process. Systemic endothelial dysfunction is an early sign of the atherosclerotic process and can be assessed by ultrasonography of the brachial artery.


METHODS
A total of 102 in-hospital patients (76 men; mean age 63.5 +/- 9.7 years) referred to the stress echocardiography laboratory underwent: 1) transthoracic echocardiography, with specific assessment of AVS (thickened valve leaflets with a transaortic flow velocity <2.5 m/s); 2) stress echocardiography; 3) coronary angiography, with evaluation of the Duke score (from 0 [normal] to 100 [most severe disease]); and 4) an endothelial function study, with assessment of endothelium-dependent, post-ischemic, flow-mediated dilation (FMD).


RESULTS
Aortic valve sclerosis was present in 35 patients (group I) and absent in 67 (group II). Groups I and II were similar in terms of the frequency of stress-induced wall motion abnormalities (35.3% vs. 19.4%, p = NS) and the angiographic Duke score (33.8 +/- 28.6 vs. 35.2 +/- 29.1, p = NS). Patients with AVS showed a markedly lower FMD than those without AVS (2.2 +/- 3.5% vs. 5.3 +/- 5.3%, p < 0.01). On multivariate analysis, only FMD was highly predictive of AVS, with an odds ratio of 1.18 for each percent decrease in FMD (95% confidence interval 1.05 to 1.32; p = 0.01).


CONCLUSIONS
Aortic valve stenosis is associated with systemic endothelial dysfunction. This observation may provide a mechanistic insight into the emerging association between AVS and cardiovascular events.
Poggianti
Elisa
E
Echocardiography Laboratory, Institute of Clinical Physiology, CNR, Pisa, Italy.
Venneri
Lucia
L
Chubuchny
Vlad
V
Jambrik
Zoltan
Z
Baroncini
Liz Andrea
LA
Picano
Eugenio
E
D000368:Aged; D001021:Aortic Valve / Q000473:pathology*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D001161:Arteriosclerosis / Q000150:complications*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications; D004108:Dilatation, Pathologic; D004452:Echocardiography; D025401:Echocardiography, Stress; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012598:Sclerosis; D014463:Ultrasonography