title: Association of aortic valve sclerosis and coronary artery disease in patients with severe nonischemic mitral regurgitation.
abstract: BACKGROUND
  The presence of aortic valve sclerosis accounts for a higher rate of ischemic events and increased cardiovascular mortality. It may reflect coronary artery disease (CAD) because of a shared pathologic background.
  
  
  OBJECTIVE
  We aimed to analyze whether the presence of aortic valve sclerosis might help in identifying patients with coronary atherosclerosis among those with severe nonischemic mitral regurgitation (MR), who undergo coronary angiography before surgery for screening, and not because of suspected ischemic heart disease.
  
  
  METHODS
  In all, 84 patients (mean age 64 +/- 9 years; 71% men) with mitral valve prolapse and severe regurgitation underwent echocardiography and coronary angiography. Aortic valve sclerosis was defined as focal areas of increased echogenicity and thickening of the leaflets without restriction of leaflet motion on echocardiography. Coronary artery disease was defined by the presence/absence of atherosclerotic plaques, independent of the degree of stenosis.
  
  
  RESULTS
  Coronary artery disease was diagnosed in 47.6% of patients with and 15.8% of those without aortic valve sclerosis (p = 0.008). On logistic regression analysis, the presence of aortic valve sclerosis predicted CAD (odds ratio 3.3, 95% confidence interval 1.03-10.5; p = 0.04) independent of age. In female patients, the risk ratio for CAD in the presence of aortic valve sclerosis was 9.
  
  
  CONCLUSIONS
  Coronary artery atherosclerosis and aortic valve sclerosis are closely associated in patients with severe nonischemic MR.
authors.affiliation: Department of Biomedical and Surgical Science, Cardiology Section, University of Verona, Verona, Italy. Andrea.Rossi@univr.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Gerald
authors.initials: G
authors.lastname: Bertagnolli
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: Cicoira
authors.forename: Giorgio
authors.initials: G
authors.lastname: Golia
authors.forename: Luisa
authors.initials: L
authors.lastname: Zanolla
authors.forename: Francesco
authors.initials: F
authors.lastname: Santini
authors.forename: Claudio
authors.initials: C
authors.lastname: Cemin
authors.forename: Gabriele
authors.initials: G
authors.lastname: Ferrario
authors.forename: Piero
authors.initials: P
authors.lastname: Zardini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000473:pathology*; D001161:Arteriosclerosis / Q000150:complications* / Q000473:pathology; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications* / Q000473:pathology / Q000601:surgery; D015995:Prevalence; D012107:Research Design; D012189:Retrospective Studies; D012307:Risk Factors; D012598:Sclerosis