Relationship between aortic valve sclerosis and different vascular damage markers: an observational study

KORKMAZ ATA, Ayça; KORKMAZ, Levent; ACAR, Zeydin; Erkan, Hakan; AĞAÇ, Mustafa Tarık; ÇELİK, Şükrü

Relationship between aortic valve sclerosis and different vascular damage markers: an observational study

Levent KORKMAZ, (Sağlık Bakanlığı, Ahi Evren Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Trabzon, Türkiye)

Mustafa Tarık AĞAÇ, (Sağlık Bakanlığı, Ahi Evren Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Trabzon, Türkiye)

Ayça KORKMAZ ATA, (Akçaabat Devlet Hastanesi, Radyoloji Anabilim Dalı, Trabzon, Türkiye)

Hakan ERKAN, (Sağlık Bakanlığı, Ahi Evren Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Trabzon, Türkiye)

Zeydin ACAR, (Sağlık Bakanlığı, Ahi Evren Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Trabzon, Türkiye)

Şükrü ÇELİK (Sağlık Bakanlığı, Ahi Evren Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Trabzon, Türkiye)

Anadolu Kardiyoloji Dergisi

0 0

Yıl: 2013 Cilt: 13 Sayı: 5 Sayfa Aralığı: 452 - 456 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Relationship between aortic valve sclerosis and different vascular damage markers: an observational study

Öz:

Amaç: Aort kapak sklerozu (AKS) ile atheroklerosis arasında bir ilişki olduğu düşünülse de AKS'nin patogenezinde nonaterosklerotik procesin rol alıp almadığı konusunda yeterli bilgi bulunmamaktadır. Çalışmanın amacı bunu test etmekti. Yöntemler: Gözlemsel ve kesitsel çalışmamımızda AKS'si olan 60 hasta ve kardiyovasküler risk faktörleri eşleştirilmiş 76 kontrol grubu çalışmaya alınmıştır. Aplanasyon tonometri ile puls-dalga hız (PWV) ve augmentasyon indeksi değerlendirildi. B-mode ultrasound ile intima-medya kalınlığı (İMK) değerlendirildi. Eşleştirilmemiş t / Mann-Whitney U testleri ve lojistik regresyon analiz yapıldı. Bulgular: Kontrol ve AVS grubları arasında augmentasyon indeksi ve PWV açısından bir fark yoktu (11,2±3,6-12±3,2, P=0,18 ve 26±7, 6-27±9,8, P=0,2, sırasıyla). Fakat İMK AVS'li grupta anlamlı olarak yüksek bulundu (0,76 mm±0,17-0,6 mm±0,16; P<0,001). AKS ile yaş (r=0,36, p<0,001), augmentasyon indeksi (r=0,17, p:0,04), IMT (r=0,43, p<0,001) ve erkek cinsiyet (r=0,31, p<0,001) arasında anlamlı bir ilişki gözlemlenirken logistik regresyon analizde İMK (OR: 1,46, %95 CI: 1,1-1,9, p=0,009) ve yaş (OR: 1,1, %95 CI: 1,01-1,16, p=0,013) AKS'nin bağımsız prediktörleri olarak bulundu. Sonuç: AKS'li hastalarda kontrol gruba göre artmış İMK ve normal PWV AKS'nin değil arteriyal stiffnes`in aterosklerotik ve ateroskleroz dışı parametrelerden etkilendiğini gösterebilir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Aort kapak sklerozu ile damarsal hasarı gösteren farklı parametreler arasındaki ilişki: gözlemsel bir çalışma

Öz:

Objective: Although aortic valve sclerosis (AVS) and atherosclerosis may share same atherosclerotic process, there is still a controversy whether AVS may be related to atherosclerotic and nonatherosclerotic processes. The purpose of present study was to investigate this relation. Methods: In this cross-sectional and observational study, we enrolled 60 patients diagnosed with AVS and risk factor matched 76 subjects without AVS. Applanation tonometry was applied to assess the augmentation index and aortic pulse-wave velocity (PWV). Control and AVS group were examined by B-mode ultrasound to measure the intima-media thickness (IMT). Continuous variables were compared using unpaired t-test and Mann-Whitney U test. Logistic regression analysis was performed in order to find independent predictors of AVS. Results: PWV and augmentation index did not differ between control and AVS groups (11.2±3.6 vs 12±3.2, p=0.18 and 26±7.6 vs 27±9.8, p=0.2 respectively). But IMT was significantly higher in AVS group than in control one (0.76 mm±0.17 vs 0.6 mm±0.16; p<0.001). There was a significant positive bivariate correlation between the presence of AVS, IMT (r=0.43, p<0.001), male gender(r=0.31, p<0.001), augmentation index (r=0.17, p:0,04), and age (r=0.36, p<0.001). Logistic regression analysis demonstrated that only IMT (OR: 1.46, 95% CI: 1.1-1.9, p=0.009) and age (OR: 1.1, 95% CI: 1.01-1.16, p=0.013) were independent predictors of AVS. Conclusion: Increased IMT but not PWV in subjects with AVS compared to control group may suggest that, AVS is probably a multifactorial disease, related to the both atherosclerotic and nonatherosclerotic processes.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, et al. Clinical factors associated with calcific aortic valve disease: Cardiovascular Health Study. J Am Coll Cardiol 1997; 29: 630-4. [CrossRef]
2. Agmon Y, Khandheria BK, Meissner I, Sicks JR, OFallon WM, Wiebers DO, 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: 827-34. [CrossRef]
3. Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS. Association of aortic-valve sclerosis with cardiovascular mortality and morbidity in the elderly. N Engl J Med 1999; 341: 142-7. [CrossRef]
4. Otto CM, Kuusisto J, Reichenbach DD, Gown AM, OBrien KD. Characterization of the early lesion of degenerative valvular aortic stenosis. Histological and immunohistochemical studies. Circulation 1994; 90: 844-53. [CrossRef]
5. OBrien KD, Kuusisto J, Reichenbach DD, Ferguson M, Giachelli C, Alpers CE, et al. Osteopontin is expressed in human aortic valvular lesions. Circulation 1995; 92: 2163-8. [CrossRef]
6. Yamaura Y, Nishida T, Watanabe N, Akasaka T, Yoshida K. Relation of aortic valve sclerosis to carotid artery intima-media thickening in healthy subjects. Am J Cardiol 2004; 94: 837-9. [CrossRef]
7. Çelik S, Durmuş I, Korkmaz L, Gedikli O, Kaplan S, Örem C, et al. Aortic pulse wave velocity in subjects with aortic valve sclerosis. Echocardiography 2008; 25: 1112-6.
8. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation 2002; 106: 3143-421.
9. Pohle K, Maffert R, Ropers D, Moshge W, Stilianakis N, Daniel WG, et al. Progression of aortic valve calcification: association with coronary atherosclerosis and cardiovascular risk factors. Circulation 2001; 104: 1927-32. [CrossRef]
10. Adler Y, Levinger U, Koren A, Tanne D, Fink N, Vaturi M, et al. Relation of nonobstructive aortic valve calcium to carotid arterial atherosclerosis. Am J Cardiol 2000; 86: 1102-5. [CrossRef]
11. OBrien KD, Shavelle DM, Caulfield MT, McDonald TO, Olin-Lewis K, Otto CM, et al. Association of angiotensin-converting enzyme with low-density lipoprotein in aortic valvular lesions and in human plasma. Circulation 2002; 106: 2224-30. [CrossRef]
12. Völzke H, Haring R, Lorbeer R, Wallaschofski H, Reffelmann T, Empen K, et al. Heart valve sclerosis predicts all-cause and cardiovascular mortality. Atherosclerosis 2010; 209: 606-10. [CrossRef]
13. Howard G, Sharrett AR, Heiss G, Evans GW, Chambless LE, Riley WA, et al. Carotid artery intimalmedial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators. Stroke 1993; 24: 1297-304. [CrossRef]
14. Grobbee DE, Bots ML. Carotid artery intimamedia thickness as an indicator of generalized atherosclerosis. J Intern Med 1994; 236: 567-73. [CrossRef]
15. Salonen R, Salonen JT. Determinants of carotid intimamedia thickness: a population-based ultrasonography study in eastern Finnish men. J Intern Med 1991; 229: 225-31. [CrossRef]
16. Davis PH, Dawson JD, Riley WA, Lauer RM. Carotid intimal-media thickness is related to cardiovascular risk factors measured from childhood through middle age: The Muscatine Study. Circulation 2001; 104: 2815-9. [CrossRef]
17. Cuomo S, Gaeta G, Guarini P Tudisca G, De Michele M, Gene Bond M, et al. Increased carotid intima-media thickness in healthy young subjects with a parental history of hypertension (parental hypertension and vascular health). Heart 2007; 93: 368-9. [CrossRef]
18. Cecelja M, Chowienczyk P Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension 2009; 54: 1328-36. [CrossRef]
19. Antonini-Canterin F, Di Bello V, Di Salvo G, La Carrubba S, Bellieni G, Benedetto F, et al. Relation of carotid intima-media thickness and aortic valve sclerosis (from the ISMIR study ["Ispessimento Medio Intimale e Rischio Cardiovascolare"] of the Italian Society of Cardiovascular Echography). Am J Cardiol 2009; 103: 1556-61.

APA	KORKMAZ L, AĞAÇ M, KORKMAZ ATA A, Erkan H, ACAR Z, ÇELİK Ş (2013). Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. , 452 - 456.
Chicago	KORKMAZ Levent,AĞAÇ Mustafa Tarık,KORKMAZ ATA Ayça,Erkan Hakan,ACAR Zeydin,ÇELİK Şükrü Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. (2013): 452 - 456.
MLA	KORKMAZ Levent,AĞAÇ Mustafa Tarık,KORKMAZ ATA Ayça,Erkan Hakan,ACAR Zeydin,ÇELİK Şükrü Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. , 2013, ss.452 - 456.
AMA	KORKMAZ L,AĞAÇ M,KORKMAZ ATA A,Erkan H,ACAR Z,ÇELİK Ş Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. . 2013; 452 - 456.
Vancouver	KORKMAZ L,AĞAÇ M,KORKMAZ ATA A,Erkan H,ACAR Z,ÇELİK Ş Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. . 2013; 452 - 456.
IEEE	KORKMAZ L,AĞAÇ M,KORKMAZ ATA A,Erkan H,ACAR Z,ÇELİK Ş "Relationship between aortic valve sclerosis and different vascular damage markers: an observational study." , ss.452 - 456, 2013.
ISNAD	KORKMAZ, Levent vd. "Relationship between aortic valve sclerosis and different vascular damage markers: an observational study". (2013), 452-456.

APA	KORKMAZ L, AĞAÇ M, KORKMAZ ATA A, Erkan H, ACAR Z, ÇELİK Ş (2013). Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. Anadolu Kardiyoloji Dergisi, 13(5), 452 - 456.
Chicago	KORKMAZ Levent,AĞAÇ Mustafa Tarık,KORKMAZ ATA Ayça,Erkan Hakan,ACAR Zeydin,ÇELİK Şükrü Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. Anadolu Kardiyoloji Dergisi 13, no.5 (2013): 452 - 456.
MLA	KORKMAZ Levent,AĞAÇ Mustafa Tarık,KORKMAZ ATA Ayça,Erkan Hakan,ACAR Zeydin,ÇELİK Şükrü Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. Anadolu Kardiyoloji Dergisi, vol.13, no.5, 2013, ss.452 - 456.
AMA	KORKMAZ L,AĞAÇ M,KORKMAZ ATA A,Erkan H,ACAR Z,ÇELİK Ş Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. Anadolu Kardiyoloji Dergisi. 2013; 13(5): 452 - 456.
Vancouver	KORKMAZ L,AĞAÇ M,KORKMAZ ATA A,Erkan H,ACAR Z,ÇELİK Ş Relationship between aortic valve sclerosis and different vascular damage markers: an observational study. Anadolu Kardiyoloji Dergisi. 2013; 13(5): 452 - 456.
IEEE	KORKMAZ L,AĞAÇ M,KORKMAZ ATA A,Erkan H,ACAR Z,ÇELİK Ş "Relationship between aortic valve sclerosis and different vascular damage markers: an observational study." Anadolu Kardiyoloji Dergisi, 13, ss.452 - 456, 2013.
ISNAD	KORKMAZ, Levent vd. "Relationship between aortic valve sclerosis and different vascular damage markers: an observational study". Anadolu Kardiyoloji Dergisi 13/5 (2013), 452-456.