Lindroos M, Kupari M, Heikkilä J, Tilvis R
First Department of Medicine, Helsinki University Central Hospital, Finland.
J Am Coll Cardiol. 1993 Apr;21(5):1220-5. doi: 10.1016/0735-1097(93)90249-z.
This study was undertaken to elucidate the prevalence of aortic valve abnormalities in the elderly.
The age of persons treated actively for valve disorders is increasing. More information is needed about the prevalence of aortic valve disease in old age.
Randomly selected men and women in the age groups 75 to 76, 80 to 81 and 85 to 86 years (n = 501) participating in the Helsinki Ageing Study were studied with imaging and Doppler echocardiography. Additionally, 76 persons 55 to 71 years of age were included. The systolic aortic valve area was calculated by the continuity equation. The velocity ratio (peak velocity in the left ventricular outflow tract/peak velocity across the aortic valve) was a supplementary criterion for aortic stenosis. Valve regurgitation and cusp calcification were assessed visually.
Evaluation of the aortic valve was possible in 552 persons (96%). Mild calcification was found in 222 (40%) and severe calcification in 72 (13%). Two persons (0.4%) had an aortic valve prosthesis. Critical native valve stenosis (calculated aortic valve area < or = 0.8 cm2 and velocity ratio < or = 0.35) was found in 12 persons (2.2%). Six of these were symptomatic and potentially eligible for valvular surgery. All persons with aortic valve stenosis were in the three oldest age groups. The prevalence of critical aortic valve stenosis was 2.9% (95% confidence interval 1.4% to 5.1%) in the group 75 to 86 years of age. Aortic regurgitation, mostly mild, was found in 29% of the entire study cohort.
Calcific aortic valve stenosis constitutes a significant health problem in the elderly. Only a minority of those with potentially operable aortic valve stenosis undergo surgery.
本研究旨在阐明老年人主动脉瓣异常的患病率。
积极接受瓣膜疾病治疗的人群年龄在增加。需要更多关于老年主动脉瓣疾病患病率的信息。
对参与赫尔辛基衰老研究的75至76岁、80至81岁和85至86岁年龄组的男性和女性（n = 501）进行随机抽样，并通过影像学和多普勒超声心动图进行研究。此外，还纳入了76名55至71岁的人员。通过连续性方程计算收缩期主动脉瓣面积。速度比（左心室流出道峰值速度/主动脉瓣跨瓣峰值速度）是主动脉瓣狭窄的补充标准。通过视觉评估瓣膜反流和瓣叶钙化情况。
552人（96%）的主动脉瓣得以评估。222人（40%）发现轻度钙化，72人（13%）发现重度钙化。2人（0.4%）有主动脉瓣人工瓣膜。12人（2.2%）发现严重的天然瓣膜狭窄（计算得出的主动脉瓣面积≤0.8平方厘米且速度比≤0.35）。其中6人有症状且可能符合瓣膜手术条件。所有主动脉瓣狭窄患者均在三个年龄最大的年龄组中。75至86岁年龄组中严重主动脉瓣狭窄的患病率为2.9%（95%置信区间1.4%至5.1%）。在整个研究队列中，29%发现有主动脉瓣反流，大多为轻度。
钙化性主动脉瓣狭窄是老年人的一个重大健康问题。只有少数有潜在手术适应证的主动脉瓣狭窄患者接受手术。
