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Aortic valve sclerosis is associated with systemic endothelial dysfunction
Elisa Poggianti1, Lucia Venneri, Vlad Chubuchny
1Echocardiography Laboratory, Institute of Clinical Physiology, CNR, Pisa, Italy.
Insights
Aortic valve sclerosis (AVS) is linked to systemic endothelial dysfunction, a key indicator of atherosclerosis. Lower flow-mediated dilation (FMD) significantly predicts AVS, suggesting a connection to cardiovascular events.
Area of Science:
- Cardiology
- Vascular Biology
- Atherosclerosis Research
Background:
- Aortic valve sclerosis (AVS) is increasingly recognized as a manifestation of the broader atherosclerotic process.
- Systemic endothelial dysfunction, an early marker of atherosclerosis, can be non-invasively assessed using brachial artery ultrasonography.
Purpose of the Study:
- To investigate the association between aortic valve sclerosis (AVS) and systemic endothelial dysfunction.
- To explore whether endothelial function is a predictor of AVS.
Main Methods:
- 102 in-hospital patients underwent transthoracic echocardiography for AVS assessment, stress echocardiography, coronary angiography (Duke score), and endothelial function testing (flow-mediated dilation, FMD).
- AVS was defined by thickened valve leaflets and transaortic flow velocity <2.5 m/s.
Main Results:
- Aortic valve sclerosis (AVS) was present in 35 patients and absent in 67.
- Patients with AVS exhibited significantly lower flow-mediated dilation (FMD) compared to those without AVS (2.2% vs. 5.3%, p < 0.01).
- Multivariate analysis identified FMD as a strong predictor of AVS (OR 1.18 per 1% decrease in FMD, p=0.01), independent of coronary artery disease severity.
Conclusions:
- Aortic valve sclerosis (AVS) is significantly associated with systemic endothelial dysfunction.
- This finding suggests a potential mechanistic link between AVS, endothelial dysfunction, and an increased risk of cardiovascular events.
Objectives:
We sought to examine the association between aortic valve sclerosis (AVS) and systemic endothelial manifestations of the atherosclerotic process.
Background:
Clinical and experimental studies suggest that AVS is a manifestation of the atherosclerotic process. Systemic endothelial dysfunction is an early sign of the atherosclerotic process and can be assessed by ultrasonography of the brachial artery.
Methods:
A total of 102 in-hospital patients (76 men; mean age 63.5 +/- 9.7 years) referred to the stress echocardiography laboratory underwent: 1) transthoracic echocardiography, with specific assessment of AVS (thickened valve leaflets with a transaortic flow velocity <2.5 m/s); 2) stress echocardiography; 3) coronary angiography, with evaluation of the Duke score (from 0 [normal] to 100 [most severe disease]); and 4) an endothelial function study, with assessment of endothelium-dependent, post-ischemic, flow-mediated dilation (FMD).
Results:
Aortic valve sclerosis was present in 35 patients (group I) and absent in 67 (group II). Groups I and II were similar in terms of the frequency of stress-induced wall motion abnormalities (35.3% vs. 19.4%, p = NS) and the angiographic Duke score (33.8 +/- 28.6 vs. 35.2 +/- 29.1, p = NS). Patients with AVS showed a markedly lower FMD than those without AVS (2.2 +/- 3.5% vs. 5.3 +/- 5.3%, p < 0.01). On multivariate analysis, only FMD was highly predictive of AVS, with an odds ratio of 1.18 for each percent decrease in FMD (95% confidence interval 1.05 to 1.32; p = 0.01).
Conclusions:
Aortic valve stenosis is associated with systemic endothelial dysfunction. This observation may provide a mechanistic insight into the emerging association between AVS and cardiovascular events.