Is aortic valve sclerosis in the elderly related to coronary artery disease?

Marzenna Zielinska¹, Anna Ledakowicz¹, Krzysztof Kaczmarek¹, Andrzej Walczak², Wlodzimierz Koniarek¹

Summary
Introduction: Aortic valve sclerosis (AS) is thought to be a degenerative process connected with ageing. Usually AS is asymptomatic and is revealed incidentally by echocardiography. The pathogenesis of AS remains unknown.
The aim of this study was an evaluation of the incidence of AS in patients with coronary artery disease (CAD), and an analysis of any relationship between AS and the risk factors of atherosclerosis and coronary angiography.
Material and methods: A group of 274 patients (167 men, 61%), aged 65-87 years old, hospitalised with a diagnosis of CAD was studied. The following atherosclerosis risk factors of CAD were analysed: age, sex, BMI, diabetes, arterial hypertension, current smoking, family history of CAD, and serum lipids. Each patient underwent transthoracal echocardiography (TTE), with a detailed evaluation of aortic valve morphology and function. All patients had coronary angiography.
According to the presence or absence of AS, patients were divided into groups: Group I (n=183, 63.5% men, 73.3±5.4 yrs) and Group II (n=121, 57.9% men, 71.6±4.6 yrs).
Results: None of the atherosclerotic risk factors was significantly more frequent in any group.
Coronary angiography revealed no relation between AS and CAD.
Analysis of any relation between AS and age revealed a positive correlation. The final regression model showed a high correlation between AS and age (r=0.91; r2=0.882; p=0.005).
Conclusions: 1. Aortic valve sclerosis in the elderly is not a marker for coronary artery atherosclerosis. 2. The pathomechanism of aortic valve sclerosis is probably different from that of coronary artery atherosclerosis. 3. Age is a unique independent risk factor for aortic valve sclerosis.

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