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Published on: August 28, 2018
Coronary artery disease is associated with valvular heart disease, but could it Be a predictive factor?
Anthony Matta1, Nicolas Moussallem2
1Faculty of Medicine, Holy Spirit University of Kaslik, Kaslik, Lebanon.
Insights
Coronary artery disease (CAD) affects 27.75% of patients with severe valvular heart disease (VHD), particularly those with severe aortic stenosis. Further research is needed to explore a potential causal link between these conditions.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Internal Medicine
Background:
- Valvular heart disease (VHD) and coronary artery disease (CAD) are significant cardiovascular conditions.
- The co-occurrence and potential relationship between severe VHD and significant CAD require further investigation.
Purpose of the Study:
- To determine the prevalence of significant CAD in patients with severe VHD.
- To explore the association between severe VHD and significant CAD.
- To investigate a potential causal relationship between these two cardiac entities.
Main Methods:
- A retrospective analysis of 1308 patients who underwent surgery for severe VHD between 2000 and 2016.
- Patients were categorized into four groups based on transthoracic echocardiography: severe aortic stenosis (AS), severe aortic regurgitation (AR), severe mitral stenosis (MS), and severe mitral regurgitation (MR).
- Preoperative coronary angiographies were reviewed to identify significant CAD (≥50% luminal stenosis); statistical analysis included Chi-square tests.
Main Results:
- Significant CAD was detected in 27.75% of all patients with severe VHD.
- The prevalence of CAD was higher in patients with isolated aortic valve disease (32%) compared to isolated mitral valve disease (15%).
- A significant correlation was found between CAD and aortic valve disease, particularly severe AS (p < 0.0001).
Conclusions:
- The prevalence of CAD in patients with VHD is 27.75%.
- CAD significantly correlates with aortic valve disease, especially severe AS.
- Larger studies are recommended to elucidate a possible causal relationship between VHD and CAD.
Objective:
This study was conducted to evaluate the prevalence of significant coronary artery disease (CAD) in patients with severe valvular heart disease (VHD) and the association between these two cardiac entities. Our research aims to introduce the theory of a possible causal relationship.
Methods:
A retrospective study was conducted on 1308 consecutive patients who underwent surgery for severe VHD in the cardiovascular department of Notre-Dame de Secours University Hospital (NDSUH) between December 2000 and December 2016. According to transthoracic echocardiography, patients were divided into 4 groups: patients with severe aortic stenosis (AS), patients with severe aortic regurgitation (AR), patients with severe mitral stenosis (MS), and patients with severe mitral regurgitation (MR). Preoperative coronary angiographies were reviewed for the presence or the absence of significant CAD (≥50% luminal stenosis). Chi-square test and 2 × 2 tables were used.
Results:
Of the 1308 patients with severe VHD, 1002 patients had isolated aortic valve disease, 240 patients had isolated mitral valve disease, and 66 patients had combined aortomitral valve disease. CAD was detected in 27.75% of all patients with severe VHD, in 32% of patients with isolated aortic valve disease, and in 15% of patients with isolated mitral valve disease. Statistical analysis showed a higher prevalence in patients with severe aortic valve stenosis and a significant relationship between CAD and aortic valve disease, mainly severe AS (p < 0.0001).
Conclusion:
The prevalence of CAD in patients with VHD is 27.75%, and it correlates significantly with aortic valve disease, in particular with severe AS. Future large studies are needed to evaluate the possible causal relationship.
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