Ms. Bhutani et al., A PROSPECTIVE CONTROLLED EVALUATION OF ENDOSCOPIC DETECTION OF ANGIODYSPLASIA AND ITS ASSOCIATION WITH AORTIC-VALVE DISEASE, Gastrointestinal endoscopy, 42(5), 1995, pp. 398-402
Background: In view of controversy about the association of aortic ste
nosis and angiodysplasia of the gut, we performed a prospective, contr
olled study to evaluate the relationship between aortic valve disease
and gastrointestinal angiodysplasia. Methods: Forty patients who had e
ndoscopy for clinical indications such as gastrointestinal bleeding, a
nemia, polyps, colon cancer, and dyspepsia, and who were found to have
angiodysplasia of the gastrointestinal tract, underwent two-dimension
al and Doppler echocardiography. Thirty-seven controls matched for age
, sex, indication, and nature of endoscopic examination, but without a
ngiodysplasia, underwent similar echocardiographic examination. Result
s: None of the patients in either group had aortic stenosis. The preva
lence of aortic sclerosis, aortic insufficiency, and low left ventricu
lar ejection fraction was similar in patients with and without angiody
splasia. Conclusions: This study does not support the role of aortic v
alve disease as the cause of angiodysplasia of the gastrointestinal tr
act. A subgroup of patients with angiodysplasia with aortic sclerosis,
with or without low left ventricular ejection fraction, and with or w
ithout other valvular disease (but none with aortic stenosis), had inc
reased prevalence of gastrointestinal bleeding when compared with cont
rols. When aortic valve disease or decreased left ventricular ejection
fraction were analyzed as independent predictors, none of them in and
of itself appeared to be a factor in bleeding from these gastrointest
inal lesions.