Sterbakova Gabriela, Vyskocil Vaclav, Linhartova Katerina
First Department of Medicine, Charles University School of Medicine Hospital, Pilsen, Czech Republic.
Cardiology. 2010;117(3):184-9. doi: 10.1159/000321418. Epub 2010 Nov 16.
An association between aortic valve calcification and osteoporosis has been observed. The aim of this study was to assess the association between bisphosphonate treatment for osteoporosis and the progression of calcific aortic stenosis (AS).
A retrospective study of patients with AS (mean gradient ≥10 mm Hg), preserved renal function and two echocardiographies >8 months apart was performed. The patients were divided into those treated with bisphosphonates for osteoporosis and those not treated and then subdivided into mild (mean gradient <30 mm Hg) and moderate-to-severe AS groups. We compared the annualized gradient change between the groups and identified predictors of AS progression.
We analyzed the outcomes of 103 patients (51% females, age 68 ± 10 years, follow-up 29 ± 13 months), of whom 57 had mild and 46 moderate-to-severe AS. Bisphosphonates were taken by 28 patients, of whom 22 had mild and 6 moderate-to-severe AS. In the patients with mild AS, the annualized mean gradient change was lower in the bisphosphonate-treated than in the untreated patients (0.1 ± 3.3 vs. 2.8 ± 3.3 mm Hg/year; p = 0.002) and was negatively associated with bisphosphonate treatment (β coefficient -2.36%, 95% confidence interval -4.47 to -0.26; p = 0.028) independent of age, gender and baseline gradient.
Bisphosphonate treatment was independently associated with slower progression of mild AS in patients with preserved renal function.
已观察到主动脉瓣钙化与骨质疏松之间存在关联。本研究的目的是评估骨质疏松的双膦酸盐治疗与钙化性主动脉瓣狭窄（AS）进展之间的关联。
对AS患者（平均压差≥10mmHg）、肾功能正常且两次超声心动图检查间隔>8个月的患者进行回顾性研究。患者分为接受双膦酸盐治疗骨质疏松的患者和未接受治疗的患者，然后再细分为轻度（平均压差<30mmHg）和中重度AS组。我们比较了两组之间的年化压差变化，并确定了AS进展的预测因素。
我们分析了103例患者的结果（51%为女性，年龄68±10岁，随访29±13个月），其中57例为轻度AS，46例为中重度AS。28例患者服用双膦酸盐，其中22例为轻度AS，6例为中重度AS。在轻度AS患者中，双膦酸盐治疗组的年化平均压差变化低于未治疗组（0.1±3.3 vs. 2.8±3.3mmHg/年；p=0.002），且与双膦酸盐治疗呈负相关（β系数-2.36%，95%置信区间-4.47至-0.26；p=0.028），与年龄、性别和基线压差无关。
双膦酸盐治疗与肾功能正常患者轻度AS进展较慢独立相关。
