Abstract 18200: Impact of Pulse Pressure on the Progression of Aortic Valve Calcification in Patients with Aortic Stenosis
Introduction: Hypothesis: We hypothesized that elevated arterial pulse pressure (PP=systolic blood pressure - diastolic blood pressure) increases mechanical stress on aortic valve cusps, which may, in turn accelerate the mineralization of the valve. The aim of this study was thus to determine the impact of pulse pressure on the progression of aortic valve calcification in patients with AS.
Methods: AVC was prospectively measured by Multidetector Computed Tomography (MDCT) in 75 patients at baseline and every 2 years during follow-up. AVC progression rate was assessed by the annualized increase in AVC.
Results: Patients with high PP (i.e.>60 mmHg) had faster AVC progression rate compared to those with low PP (≤60 mmHg) (annualized AVC: +64 [6 - 223] AU/yr vs. +13 [-14 - 46] AU/yr; p=0.002). In multivariate analysis adjusted for age, gender, metabolic syndrome, hypertension, creatinine level, baseline AVC, PP was an independent predictor of faster AVC progression rate (p=0.001).
Conclusions: This study shows that elevated PP is a strong independent predictor of faster AVC progression. These findings suggest that anti-hypertensive medications that are the most efficient to reduce PP (e.g. angiotensin receptor blockers) could help to slow the progression of aortic stenosis.
Author Disclosures: L.L. Tastet: None. R. Capoulade: None. J.G. Dumesnil: None. E. Larose: None. M. Shen: None. M. Clavel: None. A. Dahou: None. M. Arsenault: None. E. Bédard: None. P. Mathieu: None. P. Pibarot: None.
- © 2014 by American Heart Association, Inc.