接受诊断性冠状动脉造影的患者中主动脉瓣硬化与冠状动脉疾病程度的关系。

Relationship between aortic valve sclerosis and the extent of coronary artery disease in patients undergoing diagnostic coronary angiography.

作者信息

Soydinc Serdar, Davutoglu Vedat, Dundar Ayhan, Aksoy Mehmet

机构信息

Department of Cardiology, University of Gaziantep School of Medicine, Gaziantep, Turkey.

出版信息

Cardiology. 2006;106(4):277-82. doi: 10.1159/000093491. Epub 2006 May 29.

DOI:10.1159/000093491

PMID:16733352

Abstract

BACKGROUND

Aortic valve sclerosis (AVS) is considered to be a manifestation of coronary atherosclerosis. Recent studies demonstrated an association between AVS and significant coronary artery disease (CAD).

AIM

We sought to determine the association between AVS and the extent of coronary atherosclerosis by means of the Gensini score system, which was calculated to yield a measure of the extent and severity of coronary atherosclerosis in patients referred for coronary angiography.

METHODS

A total of 160 consecutive patients referred for coronary angiography were subjected to echocardiography for screening of AVS and coronary risk assessment. Absence (group 1, n = 110) and presence of AVS (Group 2, n = 50) was established. The cardiac risk factors considered in this study were age, gender, family history of CAD, diabetes mellitus, hypertension, hypercholesterolemia and history of smoking. The body mass index was also measured. Atherosclerotic plaque burden was determined using the Gensini score. Significant CAD was defined as >50% reduction in the internal diameter of at least one coronary artery. Multivessel coronary disease was based on the presence of 2- or 3-vessel disease.

RESULTS

The AVS patients had a higher rate of 3-vessel disease (AVS group vs. non AVS: 40 vs. 13.6%; p < 0.001). No significant correlations were found between AVS and 1- and 2-vessel disease. Individuals with AVS were found to have a higher Gensini score (40.7 +/- 38.05 vs. 18 +/- 16.4; p < 0.001). Multivariate analysis identified age (p < 0.001), male sex (p = 0.01), triglycerides (p = 0.02), LDL cholesterol (p = 0.001) and Gensini score (p = 0.003) as independent predictors of AVS.

CONCLUSION

AVS is strongly interrelated with the coronary angiographic Gensini score. Echocardiographic detection of AVS in patients undergoing coronary angiography can provide a new surrogate marker of the extent of coronary atherosclerosis.

摘要

背景

主动脉瓣硬化（AVS）被认为是冠状动脉粥样硬化的一种表现。近期研究表明AVS与显著冠状动脉疾病（CAD）之间存在关联。

目的

我们试图通过Gensini评分系统来确定AVS与冠状动脉粥样硬化程度之间的关联，该评分系统用于计算接受冠状动脉造影患者的冠状动脉粥样硬化程度和严重程度。

方法

总共160例连续接受冠状动脉造影的患者接受了超声心动图检查，以筛查AVS并进行冠状动脉风险评估。确定有无AVS（第1组，n = 110；无AVS；第2组，n = 50；有AVS）。本研究中考虑的心脏危险因素包括年龄、性别、CAD家族史、糖尿病、高血压、高胆固醇血症和吸烟史。还测量了体重指数。使用Gensini评分确定动脉粥样硬化斑块负荷。显著CAD定义为至少一条冠状动脉内径减少>50%。多支冠状动脉疾病基于存在双支或三支血管疾病。

结果

AVS患者三支血管疾病的发生率更高（AVS组与非AVS组：40%对13.6%；p < 0.001）。未发现AVS与单支和双支血管疾病之间存在显著相关性。发现有AVS的个体Gensini评分更高（40.7±38.05对18±16.4；p < 0.001）。多变量分析确定年龄（p < 0.001）、男性（p = 0.01）、甘油三酯（p = 0.02）、低密度脂蛋白胆固醇（p = 0.001）和Gensini评分（p = 0.003）是AVS的独立预测因素。