CORRELATION BETWEEN LIPOPROTEIN(A) AND AORTIC-VALVE SCLEROSIS ASSESSED BY ECHOCARDIOGRAPHY (THE JMS CARDIAC ECHO AND COHORT STUDY)

An elevated serum level of lipoprotein(a) (Lp[a]) may be an independen t risk factor for atherosclerotic disease, but the relation of Lp(a) t o aortic valve (AV) sclerosis has not been determined. We measured ser um concentrations of Lp(a) and investigated their relation to the pres ence of echocardiographic AV sclerosis in residents of a rural village in Japan. We measured serum Lp(a) levels in 347 men and 437 women age d 35 to 90 years (mean +/- SD: 62 +/- 11 years) who participated in ma ss screening examinations in Wara village, Gifu, Japan. AV sclerosis w as assessed by long- and short-axis 2-dimensional echocardiographic vi ews and continuous-wave Doppler echocardiography. AV sclerosis was gra ded as follows: 0 = normal AV; 1 = increased echo density; 2 = thicken ing or calcific deposits greater than or equal to 3 mm; and 3 = same a s 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 than in men (p < 0.01), and did not incr ease women significantly with age. he prevalence of AV sclerosis (grad es 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 greater t han or equal to 30 mg/dl and in 77 (12.7%) of 604 subject with Lp(a) l evels <30 mg/dl (p < 0.001). There were no significant differences in the prevalence of AV sclerosis in terms of sex, blood pressure, or lev els of total cholesterol, high-density lipoprotein cholesterol, trigly cerides, or blood sugar. We conclude that increased serum levels of Lp (a), as well as aging, are closely related to AV sclerosis.