Aortic valve sclerosis and aortic atherosclerosis: Different manifestations of the same disease? Insights from a population-based study

OBJECTIVES The aim of this study was to examine the association between ath erosclerosis risk factors, aortic atherosclerosis and aortic valve abnormal ities in the general population. BACKGROUND Clinical and experimental studies suggest that aortic valve scle rosis (AVS) is a manifestation of the atherosclerotic process. METHODS Three hundred eighty-one subjects, a sample of the Olmsted County ( Minnesota) population, were examined by transthoracic and transesophageal e chocardiography. The presence of AVS (thickened valve leaflets), elevated t ransaortic flow velocities and aortic regurgitation (AR) was determined. Th e associations between atherosclerosis risk factors, aortic atherosclerosis (imaged by transesophageal echocardiography) and aortic valve abnormalitie s were examined. RESULTS Age, male gender, body mass index (odds ratio [OR]: 1.07 per kg/m(2 ); 95% confidence interval [CI]: 1.02 to 1.12), antihypertensive treatment (OR: 1.93; CI: 1.12 to 3.32) and plasma homocysteine levels (OR: 1.89 per t wofold increase; CI: 0.99 to 3.61) were independently associated with an in creased risk of AVS. Age, body mass index and pulse pressure (OR: 1.21 per 10 mm Hg; CI: 1.00 to 1.46) were associated with elevated (upper quintile) transaortic velocities, whereas only age was independently associated with AR. Sinotubular junction sclerosis (p = 0.001) and atherosclerosis of the a scending aorta (p = 0.03) were independently associated with AVS and elevat ed transaortic velocities, respectively. CONCLUSIONS Atherosclerosis risk factors and proximal aortic atherosclerosi s are independently associated with aortic valve abnormalities in the gener al population. These observations suggest that AVS is an atherosclerosis-li ke process involving the aortic valve. (C) 2001 by the American College of Cardiology.