title: Lipoprotein(a) is a risk factor for aortic and mitral valvular stenosis in peripheral arterial disease.
abstract: OBJECTIVE
  Lipoprotein(a) (Lp(a)) levels have been associated with aortic valvular calcification and stenosis. The prevalence and risk factors, including Lp(a) level, for valvular heart disease (VHD) were investigated in patients with peripheral arterial disease (PAD).
  
  
  RESULTS
  Echocardiography was performed in 861 patients with PAD to detect abnormal cardiac findings. Relationships between VHD and risk factors were analysed. The prevalence of VHD was 43.6%, and the prevalences of aortic valve regurgitation (AR), mitral valve regurgitation (MR), aortic valve stenosis (AS), mitral valve stenosis (MS), and tricuspid regurgitation (TR) were 26.8, 19.7, 5.9, 1.3, and 9.4%, respectively. In stepwise multiple regression analysis, severity of AR was related to age, albumin, and estimated glomerular filtration rate (eGFR); MR was related to eGFR and age; AS was related to eGFR, Lp(a), and age; MS was related to Lp(a) and female gender; and TR was related to age, body mass index, and total cholesterol (all P < 0.05). Lp(a) level was higher in patients with AS compared with those without AS [34.0 (16.7-50.0) vs. 20.0 (11.0-35.0) mg/dL, P = 0.002], in patients with MS compared with those without MS [37.0 (21.5-77.3) vs. 21.0 (11.0-35.0), P = 0.037], and in patients with AS and/or MS compared with those without AS and MS [34.0 (17.3-50.0) vs. 20.0 (11.0-35.0), P = 0.001]. Lp(a) levels were related to low-density lipoprotein cholesterol and high-sensitivity C-reactive protein levels (P = 0.004).
  
  
  CONCLUSIONS
  The high prevalence of VHD is found, especially in AR and MR, and the Lp(a) level is associated with increased risks of AS and MS in patients with PAD.
authors.affiliation: Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shibukawa, Gunma, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hojo
authors.affiliation: Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shibukawa, Gunma, Japan kumakura@sannet.ne.jp.
authors.forename: Hisao
authors.initials: H
authors.lastname: Kumakura
authors.affiliation: Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shibukawa, Gunma, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kanai
authors.affiliation: Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shibukawa, Gunma, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Iwasaki
authors.affiliation: Department of Vascular Medicine, Vascular Center, Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Shibukawa, Gunma, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ichikawa
authors.affiliation: Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D001024:Aortic Valve Stenosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007564:Japan / Q000453:epidemiology; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008946:Mitral Valve Stenosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D058729:Peripheral Arterial Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D017270:Lipoprotein(a)
keywords: aortic valve stenosis; lipoprotein(a); mitral valve stenosis; peripheral arterial disease; valvular heart disease