Relation between progression of aortic valve sclerosis and carotid intima-media thickening in asymptomatic subjects with cardiovascular risk factors.
BACKGROUND
Aortic valve sclerosis (AVS) is the early lesion of calcific aortic valve disease and may subsequently progress toward valvular stenosis. Histopathological and clinical evidence has suggested that AVS and atherosclerosis share similar mechanisms. However, little is known regarding the relation between the early AVS progression and the early atherosclerosis progression. The carotid intima-media thickness (IMT) by carotid ultrasonography has been established as the surrogate marker of the early atherosclerosis. The aim of this study was to examine the association between progression of early AVS and increase of carotid IMT.


METHODS
We retrospectively analyzed the data of 127 asymptomatic subjects (49 ± 8 years, 114 men) with ≥1 cardiovascular (CV) risk factors, without history of CV disease, who underwent echocardiographic and carotid ultrasonographic examinations twice ≥6 months apart. We evaluated aortic valve morphology and function and carotid IMT at the baseline and at follow-up examinations.


RESULTS
During a follow-up of 25 ± 15 months, the number of subjects with AVS was significantly increased (34 vs. 47%, P < 0.0001) and the mean value of carotid IMT was significantly increased (1.16 ± 0.33 vs. 1.29 ± 0.41 mm, P < 0.0001). The progression of AVS was observed in 26 subjects. By logistic regression analysis, the baseline carotid IMT value was an independent predictor of AVS progression (odds ratio = 4.07, P = 0.026).


CONCLUSIONS
In asymptomatic subjects with CV risk factors, progression of AVS and increase of carotid IMT were observed during a mean follow-up period of 25 months. Progression of AVS in asymptomatic subjects with CV risk factors was associated with carotid intima-media thickening.
Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan. yasuko-yamaura@mvj.biglobe.ne.jp.|Division of Cardiology, Hyogo Health Service Association, 4-4-20 Mikage-Honmachi, Higashinada-ku, Kobe, 658-0046, Japan. yasuko-yamaura@mvj.biglobe.ne.jp.
Yasuko
Y
Yamaura
Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
Nozomi
N
Watanabe
Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
Kikuko
K
Obase
Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
Akihiro
A
Hayashida
Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
Hiroyuki
H
Okura
Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
Kiyoshi
K
Yoshida
Aortic valve sclerosis; Calcific aortic valve disease; Cardiovascular risk factors; Carotid intima–media thickness