Seo Jeong-Hun, Chun Kwang-Jin, Lee Bong-Ki, Cho Byung-Ryul, Ryu Dong Ryeol
Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Korea.
Division of Cardiology, Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
J Cardiovasc Imaging. 2018 Dec;26(4):229-237. doi: 10.4250/jcvi.2018.26.e27. Epub 2018 Dec 21.
Statins are thought to have little effect on the progression of aortic stenosis, but the data on their role in patients with aortic valve sclerosis (AVS) are limited and inconsistent.
We retrospectively analyzed 541 consecutive patients (214 men, age: 70 ± 11 years) with AVS. Each patient underwent two or more electrocardiography examinations at least 6 months apart at Kangwon National University Hospital from August 2010 to August 2015. AVS is defined as irregular thickening of the leaflets, focal increases in echogenicity and minimal elevation of the peak aortic valve velocity (> 1.5 and < 2 m/s). The progression rate of AVS was expressed as the increase in peak velocity per year (m/s/yr).
The mean follow-up duration was 24.9 ± 13.3 months in the statin-treated group and 24.1 ± 12.4 months in the non-statin-treated group (p = 0.460). There were no differences between the statin-treated and non-statin-treated groups in mean age, gender or smoking status. Relative to the non-statin-treated group, a higher number of patients in the statin-treated group had hypertension, diabetes, ischemic heart disease, and stroke. The progression rate of AVS did not differ between the statin-treated and non-statin-treated groups (0.012 ± 0.340 m/s/yr vs. 0.014 ± 0.245 m/s/yr, p = 0.956). Multivariate analysis showed initial peak aortic jet velocity was significantly associated with AVS progression (β = 0.153, p = 0.009).
Our study demonstrated that statins had no effect on the progression of AVS. However, well-designed studies are needed to define the prognosis and management of AVS.
他汀类药物被认为对主动脉瓣狭窄的进展影响甚微,但关于其在主动脉瓣硬化(AVS)患者中作用的数据有限且不一致。
我们回顾性分析了541例连续性AVS患者(214例男性,年龄:70±11岁)。2010年8月至2015年8月期间,每位患者在江原国立大学医院接受了至少间隔6个月的两次或更多次心电图检查。AVS定义为瓣叶不规则增厚、回声增强以及主动脉瓣峰值流速轻度升高(>1.5且<2 m/s)。AVS的进展速率以每年峰值流速的增加量(m/s/年)表示。
他汀类药物治疗组的平均随访时间为24.9±13.3个月,非他汀类药物治疗组为24.1±12.4个月(p = 0.460)。他汀类药物治疗组和非他汀类药物治疗组在平均年龄、性别或吸烟状况方面无差异。与非他汀类药物治疗组相比,他汀类药物治疗组中患有高血压、糖尿病、缺血性心脏病和中风的患者更多。他汀类药物治疗组和非他汀类药物治疗组之间AVS的进展速率无差异(0.012±0.340 m/s/年对0.014±0.245 m/s/年,p = 0.956)。多变量分析显示,初始主动脉峰值射流速度与AVS进展显著相关(β = 0.153,p = 0.009)。
我们的研究表明,他汀类药物对AVS的进展没有影响。然而,需要设计完善的研究来明确AVS的预后和管理。