Aortic valve calcification and increased stiffness of the proximal thoracic ascending aorta: association with left ventricular diastolic dysfunction and early chronic kidney disease.
OBJECTIVE
The aim of this study was to clarify the relationship between the severity of aortic valve calcification (AVC) and stiffness of the proximal thoracic ascending aorta (TAA), and to examine their influence on left ventricular (LV) function and renal function.


METHODS
A total of 138 hypertensive patients including 32 with diabetes mellitus and 60 with dyslipidemia were divided into four groups based on the severity of AVC. We analyzed the elastic properties of the proximal TAA from the following strain-rate indices based on tissue Doppler imaging: maximum strain rate [SR(+)], minimum SR [SR(-)], and the time between the QRS peak and the peak SR(-) of the proximal TAA (SRT).


RESULTS
SR(+) and SRT were significantly greater in patients with moderate AVC than in patients with mild AVC. SRT and SR(-) were well correlated with age, peak velocity across AV, TAA wall thickness (IMC), LV diastolic function, and renal function. SRT was independently related to IMC, dyslipidemia, and LV diastolic function.


CONCLUSIONS
The severity of AVC was correlated with the elastic properties of the proximal TAA. The SR indices are useful for assessing the relation of TAA stiffness to LV function and renal function in patients with AVC.
Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8603, Japan. hirohomma@nms.ac.jp.
Hiroshi
H
Honma
Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8603, Japan.
Tadaaki
T
Ohno
Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8603, Japan.
Yukichi
Y
Tokita
Laboratory of Ultrasonography, Nippon Medical School Hospital, Tokyo, Japan.
Tsuyako
T
Matsuzaki
Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8603, Japan.
Hiroyuki
H
Fujimoto
Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8603, Japan.
Aya
A
Yoshinaga
Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8603, Japan.
Shoko
S
Sato
Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8603, Japan.
Tomoko
T
Yokoshima
Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8603, Japan.
Keiko
K
Ito
Division of Cardiology, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo, Tokyo, 113-8603, Japan.
Kyoichi
K
Mizuno
Aortic stiffness; Aortic valve calcification; Chronic kidney dysfunction; Left ventricular diastolic function