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Correlation between lipoprotein(a) and aortic valve sclerosis assessed by echocardiography (the JMS Cardiac Echo and
T Gotoh1, T Kuroda, M Yamasawa
1Department of Internal Medicine, Wara National Health Insurance Hospital, Gifu, Japan.
Insights
Elevated lipoprotein(a) [Lp(a)] levels are linked to aortic valve sclerosis, independent of age. This finding highlights Lp(a) as a potential risk factor for AV sclerosis, particularly in women.
Area of Science:
- Cardiology
- Biochemistry
- Epidemiology
Background:
- Elevated serum lipoprotein(a) [Lp(a)] is a potential risk factor for atherosclerotic disease.
- The association between Lp(a) and aortic valve (AV) sclerosis remains undetermined.
Purpose of the Study:
- To investigate the relationship between serum Lp(a) concentrations and the presence of echocardiographically determined AV sclerosis.
- To assess AV sclerosis in a Japanese rural population.
Main Methods:
- Serum Lp(a) levels were measured in 784 Japanese adults (aged 35-90).
- AV sclerosis was assessed using 2D echocardiography and Doppler.
- AV sclerosis was graded, and Lp(a) levels were correlated with AV sclerosis prevalence.
Main Results:
- Serum Lp(a) levels were significantly higher in women than men.
- AV sclerosis prevalence increased significantly with age.
- Subjects with Lp(a) levels ≥ 30 mg/dl had a higher prevalence of AV sclerosis (36.1%) compared to those with levels < 30 mg/dl (12.7%).
Conclusions:
- Increased serum Lp(a) levels are closely related to AV sclerosis.
- Aging is also a significant factor associated with AV sclerosis.
- Lp(a) may be an independent risk factor for AV sclerosis.
Abstract:
An elevated serum level of lipoprotein(a) (Lp[a]) may be an independent risk factor for atherosclerotic disease, but the relation of Lp(a) to aortic valve (AV) sclerosis has not been determined. We measured serum concentrations of Lp(a) and investigated their relation to the presence of echocardiographic AV sclerosis in residents of a rural village in Japan. We measured serum Lp(a) levels in 347 men and 437 women aged 35 to 90 years (mean +/- SD: 62 +/- 11 years) who participated in mass screening examinations in Wara village, Gifu, Japan. AV sclerosis was assessed by long- and short-axis 2-dimensional echocardiographic views and continuous-wave Doppler echocardiography. AV sclerosis was graded as follows: 0 = normal AV; 1 = increased echo density; 2 = thickening or calcific deposits > or = 3 mm; and 3 = same as 2 with mildly restricted motion (pressure gradient < 16 mm Hg). Lp(a) levels ranged from < 1 mg/dl to 153 mg/dl. The 25th, 50th, and 75th percentile values were 7, 16, and 28 mg/dl, respectively. Lp(a) levels were significantly higher in women than in men (p < 0.01), and did not increase significantly with age. The prevalence of AV sclerosis (grades 2 and 3) increased significantly with age (p < 0.001). AV sclerosis was present in 65 (36.1%) of 180 subjects with Lp(a) levels > or = 30 mg/dl and in 77 (12.7%) of 604 subjects with Lp(a) levels < 30 mg/dl (p < 0.001). There were no significant differences in the prevalence of AV sclerosis in terms of sex, blood pressure, or levels of total cholesterol, high-density lipoprotein cholesterol, triglycerides, or blood sugar. We conclude that increased serum levels of Lp(a), as well as aging, are closely related to AV sclerosis.