Abstract 8792: Aortic Valve Sclerosis on Echocardiography as a Marker of the Extent and Vulnerability of Coronary Artery Plaque in Patients With Suspected Coronary Artery Disease
Background: Aortic valve sclerosis (AVS) is an active and highly regulated process with histological similarities to atherosclerosis and is associated with coronary artery disease (CAD). However, the relationship between AVS and coronary plaque vulnerability is unclear. We sought to examine the relation of AVS on echocardiography to the extent and vulnerability of coronary artery plaque as detected by computed tomography (CT) angiography.
Methods: We enrolled 66 suspected CAD patients with AVS (age: 60 ± 5 years, 71% men) who underwent both echocardiography and 64-multidetector CT. AVS was defined as focal areas of increased echogenicity and thickning of the aortic valve cusps with a transthoracic velocity less than 2.5 m/s. The Results were compared to those from 66 controls with no AVS matched by age and sex. Coronary arteries were assessed using a 17-segment model for the presence of obstructive CAD (> 50% lumen narrowing) and the segment numbers of non-calcified coronary plaque (NCP). Coronary artery calcification (CAC) was scored by Agatston method. Furthermore, the vulnerable plaque (VP) was defined as if three characteristics including low CT density (minimum CT density < 39 HU), positive remodeling, and adjacent spotty calcification were all present.
Results: The prevalence of obstructive CAD was 38%, and detectable NCPs and VPs were found in 65% and 24%, respectively. The median CAC score was 42. Patients with AVS had a higher prevalence of obstructive CAD (53 vs. 23%, p < 0.001) and that of VP (32 vs. 15%, p = 0.024), a higher median CAC score (164 vs. 5, p < 0.001), and a greater extent of NCP (2.9 ± 2.7 vs. 1.1 ± 1.5 segments, p < 0.001) compared to control patients. After adjustment for age, gender and traditional risk factors, AVS remained as an independent predictor for the presence of obstructive CAD (OR [95%CI] 3.68 [1.39–9.74], p = 0.009) and that of VP (3.79 [1.20–11.9], p = 0.023). Also it was independently correlated with the log—transformed CAC score (β-estimate [95%CI] 0.82 [0.42–1.22], p < 0.001), and the number of NCP (1.63 [0.79–2.47], p < 0.001).
Conclusion: AVS on echocardiography is associated with both extent of CAD and the presence of VP as assessed by CT angiography. This marker is useful to detect high—risk patients for future coronary events.
- © 2010 by American Heart Association, Inc.