Agmon Y, Khandheria B K, Meissner I, Sicks J R, O'Fallon W M, Wiebers D O, Whisnant J P, Seward J B, Tajik A J
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
J Am Coll Cardiol. 2001 Sep;38(3):827-34. doi: 10.1016/s0735-1097(01)01422-x.
The aim of this study was to examine the association between atherosclerosis risk factors, aortic atherosclerosis and aortic valve abnormalities in the general population.
Clinical and experimental studies suggest that aortic valve sclerosis (AVS) is a manifestation of the atherosclerotic process.
Three hundred eighty-one subjects, a sample of the Olmsted County (Minnesota) population, were examined by transthoracic and transesophageal echocardiography. The presence of AVS (thickened valve leaflets), elevated transaortic flow velocities and aortic regurgitation (AR) was determined. The associations between atherosclerosis risk factors, aortic atherosclerosis (imaged by transesophageal echocardiography) and aortic valve abnormalities were examined.
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 twofold increase; CI: 0.99 to 3.61) were independently associated with an increased 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 ascending aorta (p = 0.03) were independently associated with AVS and elevated transaortic velocities, respectively.
Atherosclerosis risk factors and proximal aortic atherosclerosis are independently associated with aortic valve abnormalities in the general population. These observations suggest that AVS is an atherosclerosis-like process involving the aortic valve.
本研究旨在探讨普通人群中动脉粥样硬化危险因素、主动脉粥样硬化与主动脉瓣异常之间的关联。
临床和实验研究表明，主动脉瓣硬化（AVS）是动脉粥样硬化进程的一种表现。
对明尼苏达州奥姆斯特德县人群的381名受试者进行经胸和经食管超声心动图检查。确定AVS（瓣膜小叶增厚）、经主动脉血流速度升高和主动脉反流（AR）的存在情况。研究动脉粥样硬化危险因素、主动脉粥样硬化（经食管超声心动图成像）与主动脉瓣异常之间的关联。
年龄、男性性别、体重指数（比值比[OR]：每kg/m²为1.07；95%置信区间[CI]：1.02至1.12）、抗高血压治疗（OR：1.93；CI：1.12至3.32）和血浆同型半胱氨酸水平（OR：每增加两倍为1.89；CI：0.99至3.61）与AVS风险增加独立相关。年龄、体重指数和脉压（OR：每10 mmHg为1.21；CI：1.00至1.46）与经主动脉流速升高（上五分位数）相关，而只有年龄与AR独立相关。窦管交界硬化（p = 0.001）和升主动脉粥样硬化（p = 0.03）分别与AVS和经主动脉流速升高独立相关。
在普通人群中，动脉粥样硬化危险因素和近端主动脉粥样硬化与主动脉瓣异常独立相关。这些观察结果表明，AVS是一个涉及主动脉瓣的类似动脉粥样硬化的过程。
