title: Markers of subclinical atherosclerosis in patients with aortic valve sclerosis: A meta-analysis of literature studies.
abstract: OBJECTIVE
  Growing evidence suggested an association between aortic valve sclerosis (AVSc) and cardiovascular (CV) events. However, little is known about the association of AVSc with major markers of subclinical atherosclerosis. We performed a meta-analysis of literature studies to address this issue.
  
  
  METHODS
  Studies on the relationship between AVSc and common carotid artery intima-media thickness (IMT), prevalence of carotid plaques (CPs), flow-mediated dilation (FMD), aortic pulse wave velocity (PWV) and augmentation index (AIx) were systematically searched in electronic databases. Thirteen studies enrolling 1086 AVSc patients and 2124 controls were included.
  
  
  RESULTS
  Compared to controls, AVSc patients showed higher IMT (MD: 0.32mm; 95%CI: 0.07, 0.58; p=0.014), and higher prevalence of CPs (OR: 4.06; 95%CI: 2.38, 6.93; p<0.001). Moreover, lower FMD (MD: -4.48%; 95%CI: -7.23, -1.74; p=0.001) and higher PWV (MD: 0.96%; 95%CI: 0.11, 1.81; p=0.027) were found in AVSc subjects than in controls, with no differences in AIx (MD: 0.76%; 95%CI: -0.97, 2.49; p=0.389). In meta-regression analyses, body mass index and triglyceride levels have an impact on the difference in IMT between cases and controls, while male gender and smoking habit were associated with the difference in the prevalence of CPs between the two groups.
  
  
  CONCLUSIONS
  AVSc is significantly associated with altered markers of subclinical atherosclerosis, thus supporting the concept that AVSc and atherosclerosis share common etiopathological mechanism and/or risk factors.
authors.affiliation: Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University, Naples, Italy. Electronic address: dario.diminno@hotmail.it.
authors.forename: Matteo Nicola Dario
authors.initials: MND
authors.lastname: Di Minno
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy; Dipartimento di Scienze Farmacologiche e Biomolecolare, Università degli Studi di Milano, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Minno
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy; Dipartimento di Scienze Farmacologiche e Biomolecolare, Università degli Studi di Milano, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Songia
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ambrosino
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Gripari
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Ravani
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: Paolo Osvaldo
authors.initials: PO
authors.lastname: Rubba
authors.affiliation: Genetic Epidemiology Unit, National Centre of Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Medda
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tremoli
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Damiano
authors.initials: D
authors.lastname: Baldassarre
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Poggio
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000209:etiology; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002114:Calcinosis / Q000175:diagnosis* / Q000209:etiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006801:Humans; D012307:Risk Factors; D014664:Vasodilation / Q000502:physiology*
keywords: Aortic valve sclerosis; Arterial stiffness; Carotid plaques; Endothelial function; Intima-media thickness; Subclinical atherosclerosis