Aortic stenosis, sclerosis, and atherosclerosis

Česká verzia

Authors: K. Linhartová ¹; R. Čerbák ²; H. Rosolová ³
Authors place of work: I. interní klinika Lékařské fakulty UK a FN Plzeň, přednosta prof. MUDr. K. Opatrný, jr. DrSc. ¹; Centrum kardiovaskulární a transplantační chirurgie Brno, ředitel prof. MUDr. J. Černý, DrSc. ²; II. interní klinika Lékařské fakulty UK a FN Plzeň, přednosta doc. MUDr. J. Filipovský, CSc. ³
Published in the journal: Vnitř Lék 2005; 51(4): 458-461
Category: Reviews

Summary

Only in the last decade calcific aortic valve disease has been proven to belong to the family of atherosclerosis. Calcific aortic valve disease encompasses a wide range of disease from calcification without flow obstruction, aortic sclerosis, to severe aortic stenosis. Similarity with the atherosclerosis is suggested by histological studies, association with atherosclerosis risk factors and frequent coincidence with coronary artery disease. Possible association with altered calcium metabolism, endothelial dysfunction, inflammatory and infectious etiology as well as genetical factors is being studied. A new insight into the problem of the aortic valve pathology may be brought through findings of new risk factors or differences between aortic valve disease and coronary artery disease. The question of causal relationship between risk factors and calcified atherosclerotic, perhaps „atheroscleritic“ aortic valve disease may be solved by prospective randomized studies.

Key words:
calcification of the aortic valve – aortic sclerosis – aortic stenosis – coronary artery disease – atherosclerosis

Zdroje

1. Davies MJ, Treasure T, Parker DJ et al. Demographic characteristics of patients undergoing aortic valve replacement for stenosis: relation to valve morphology. Heart 1996; 75: 174–178.

2. Stewart BF, Siscovick D, Lind BK et al. Clinical factors associated with calcific aortic valve disease. J Am Coll Cardiol 1997; 29: 630–634.

3. Otto C, Lind BK, Kitzman DW et al. Association of aortic valve sclerosis with cardiovascular mortality and morbidity in the elderly. N Engl J Med 1999; 341: 142–147.

4. Otto CM, Kuusisto J, Reichenbach DD et al. Characterization of the early lesion of „degenerative“ valvular aortic stenosis: histologic and immunohistochemical studies. Circulation 1994; 90: 844–853.

5. O’Brien KD, Reichenbach DD, Marcovina SM et al. Apolipoproteins B, (a) and E accumulate in the morphologically early lesion of „degenerative“ valvular aortic stenosis. Arterioscler Tromb Vasc Biol 1996; 16: 523–532.

6. Olsson M, Thyberg J, Nilsson J. Presence of oxidized low density lipoprotein in nonrheumatic stenotic aortic valves. Arterioscler Tromb Vasc Biol 1999; 19: 1218–1222.

7. Mohler ER III, Gannon F, Reynolds C et al. Bone formation and inflammation in cardiac valves. Circulation 2001; 103: 1522–1528.

8. Drolet MC, Arsenault M, Dojet J. Experimental aortic valve stenosis in rabbits. J Am Coll Cardiol 2003; 41: 1211–1217.

9. Rajamannan NM, Subramanian M, Springett M et al. Atorvastatin inhibits hypercholesterolemia-induced cellular proliferation and bone matrix production in the rabbit aortic valve. Circulation 2002; 105: 2660– 665.

10. Agmon Y, Khandheria BK, Meissner I et al. Aortic valve sclerosis and „aortic atherosclerosis“ different manifestations of the same disease? Insights from a population-based study. J Am Coll Cardiol 2001; 38: 827–834

11. Chan KL. Is aortic stenosis a preventable disease? J Am Coll Cardiol 2003; 42: 593–599.

12. Adler Y, Fink D, Spector D et al. Mitral annular calcification – a window to diffuse atherosclerosis of the vascular system. Atherosclerosis 2001; 155: 1–8.

13. Jeon DS, Atar S, Brach AV et al. Association of mitral annulus calcification, aortic valve sclerosis and aortic root calcification with abnormal myocardial perfusion single proton emission tomography in subjects age ≤ 65 years old. J Am Coll Cardiol 2001; 38: 1988–1993.

14. Yamamoto H, Shavelle D, Tarasu J et al. Valvular and thoracic calcium as a marker of the extent and severity of angiographic coronary artery disease. Am Heart J 2003; 146(1): 153–159.

15. Ortlepp JR, Schmitz F, Mevissen V et al. Lack of association between severity of coronary artery disease and aortic valve calcification determined by atomic absorption spectroscopy in 187 patients with aortic valve replacement. J Am Coll Cardiol 2004; 43: 434A.

16. Ross J jr, Braunwald E. Aortic stenosis. Circulation 1968; 38: 61–67.

17. Faggiano P, Antonini-Canterin F, Ehrlicher A et al. Progression of aortic valve sclerosis to aortic stenosis. Am J Cardiol 2003; 91: 99–101.

18. Cosmi JE, Kort S, Tunick P A. et al. The risk of the development of aortic stenosis in patients with „benign“ aortic valve thickening. Arch Intern Med 2002; 162: 2345–2347.

19. Adler Y, Vatuji M, Herz I et al. Nonobstructive aortic valve calcification: a window to significant coronary artery disease. Atherosclerosis 2002; 161: 193–197.

20. Chandra HR, Goldstein JA, Choudhary N et al. Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation. J Am Coll Cardiol 2004; 43: 169–175.

21. Otto C, O’Brien KD. Why is there discordance between calcific aortic stenosis and coronary artery disease? Heart 2001; 85: 601–602.

22. Qunibi WY, Nolan CA, Ayus JC. Cardiovascular calcification in patients with end-stage renal disease: a century old phenomenon. Kidney International 2002; 62(Suppl 82): S73–S80.

23. Merjanian R, Budoff M, Adler S et al. Coronary artery, aortic wall, and valvular calcification in nondialyzed individuals with type 2 diabetes and renal disease. Kidney International 2003; 64: 263–271.

24. Raggi P, Boulay A, Chasan-Taber S et al. Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease and cardiovascular disease? J Am Coll Cardiol 2002; 39: 695–701.

25. Mills WR, Einstadter D, Finkelhor RS et al. Calcium-phosphorus product is associated with severity of aortic stenosis in patients with normal renal function. J Am Coll Cardiol 2004; 43: 434A.

26. Ortlepp JR, Hoffmann R, Ohme F et al. The vitamin D receptor genotype predisposes to the development of calcific aortic stenosis. Heart 2001; 85: 635–638.

27. Poggianti E, Venneri L, Chubuchny V et al. Aortic valve sclerosis is associated with systemic endotelial dysfunction. J Am Coll Cardiol 2003; 41: 136–141.

28. Ghaisas NK, Foley JB, O’Briain DS et al. Adhesion molecules in nonrheumatic aortic valve disease: endothelial expression, serum levels and effects of valve replacement. J Am Coll Cardiol 2000; 36: 2257–2262.

29. Cassone A. Chlamydia pneumoniae and lipoprotein (a): the right combination for atherosclerosis? Eur Heart J 2000; 21: 559–560.

30. Glader CA, Birgander LS, Soederberg S et al. Lipoprotein (a), Chlamydia pneumoniae, leptin and tissue plasminogen activator as risk markers for valvular aortic stenosis. Eur Heart J 2003; 24: 198–208.

31. Lee TC, Zhao YD, Clourtman DW et al. Abnormal aortic valve development in mice lacking endothelial nitric oxid synthase. Circulation 2000; 101: 2345–2348.