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Coronary atherosclerosis in patients with acquired valvular disease
Tomasz Zapolski1, Andrzej Wysokiński, Jerzy Przegaliński
1Department of Cardiology, Medical Academy, Lublin, Poland.
Insights
Significant coronary artery disease is more common in patients with aortic valve disorders than mitral valve disorders. This suggests shared causes between coronary atherosclerosis and aortic valve disease, highlighting common risk factors.
Area of Science:
- Cardiology
- Vascular Medicine
- Valvular Heart Disease
Background:
- Coronary atherosclerosis frequently co-occurs with acquired valvular disorders.
- Emerging evidence suggests a potential common etiology linking these conditions.
Purpose of the Study:
- To determine the incidence of coronary atherosclerosis in patients with acquired valvular disorders.
- To compare clinical parameters and risk factor prevalence between aortic and mitral valve disease patients.
Main Methods:
- 155 patients with acquired valvular disorders underwent invasive cardiac evaluation.
- Patient groups included aortic stenosis (74), aortic insufficiency (26), mitral stenosis (33), and mitral regurgitation (14).
- Evaluations included clinical assessment, echocardiography, coronary angiography, and laboratory tests.
Main Results:
- Significant coronary lesions were more frequent in aortic valve disease (36%) compared to mitral valve disease (12.8%).
- Aortic valve disease patients were older, more often male, had more angina, less heart failure, and higher cholesterol.
- Prevalence of coronary atherosclerosis was similar between aortic stenosis and insufficiency, and between mitral stenosis and regurgitation.
Conclusions:
- Aortic valve disorders are associated with a higher incidence of significant coronary lesions than mitral valve disorders.
- The high prevalence of atherosclerotic risk factors in aortic valve disease suggests a shared etiology with coronary artery disease.
Background:
Coronary atherosclerosis often coexists with acquired valvular disorders. There is growing evidence in literature that these two conditions may have common aetiology.
Aim:
To assess the incidence of coronary atherosclerosis in patients with acquired valvular disorders and to compare clinical parameters as well as the prevalence of risk factors between patients with aortic and mitral valve diseases.
Methods:
The study group consisted of 155 patients (101 males, 54 females, mean age 58.2+/-9.7 years) with acquired valvular disorder who between 2000 and 2002 underwent invasive cardiac evaluation in our department prior to planned cardiac surgery. Aortic stenosis was detected in 74 patients, aortic insufficiency -- in 26, mitral stenosis -- in 33, and mitral regurgitation -- in 14 subjects. All patients underwent clinical evaluation, echocardiography, coronary angiography and laboratory tests.
Results:
Patients with aortic stenosis had similar prevalence of coronary atherosclerosis to patients with aortic insufficiency, and patients with mitral stenosis -- to patients with mitral regurgitation. When the two groups -- patients with aortic valve disease and patients with mitral valve disease were compared, significant coronary lesions were more often detected in patients with aortic valve disease (36% vs 12.8%, p<0.05). Also, patients with aortic valve disorder were older, predominantly of male gender, had more often angina but less often heart failure, and had higher total cholesterol level than patients with mitral valve disease.
Conclusions:
Significant coronary lesions are more frequently encountered in patients with aortic valve disorder than in those with mitral valve disease. A high prevalence of atherosclerotic risk factors in patients with aortic valve disease may suggest that this condition has similar aetiology to that of coronary artery disease.
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