Prevalence of Atherosclerosis of the Coronary and Extracranial Cerebral Arteries in Patients Undergoing Aortic Valve Replacement for Calcified Stenosis

Jens J. Kaden1, Joachim P. Eckert1, Tudor Poerner1, Dariusch Haghi1, Martin Borggrefe1, Manuela Pillich2, Judith Harrar-Haag3, Christoph Kosinski3, Jan R. Ortlepp2,4
11st Department of Medicine (Cardiology, Angiology, and Pneumology), Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, 2Medical Clinic I, 3Clinic for Neurology, 4Interdisciplinary Intermediate Care, University Hospital Aachen, University of Technology, Aachen, Germany
 

Background and aim of the study: The study aim was to investigate the coexistence of various atherosclerotic changes in patients with non-rheumatic calcific aortic valve stenosis (AS), since calcific AS shares various clinical risk factors with atherosclerosis.
Methods: In 282 consecutive patients with severe calcific stenosis of a tricuspid aortic valve scheduled for aortic valve replacement, the prevalence of atherosclerotic changes of the coronary and extracranial cerebral arteries were assessed using coronary angiography and Doppler sonography, respectively.
Results: The severities of coronary and extracranial cerebral artery atherosclerosis were significantly associated (p = 0.005). The prevalence and severity of

both coronary and extracranial cerebral artery atherosclerosis were age-dependent. Coronary or extracranial cerebral artery stenosis was present in 59% and 16% of patients, respectively, while 91% of the study population and all patients aged >80 years showed atherosclerosis of the coronary and/or extracranial cerebral arteries.
Conclusion: The data obtained indicated a very high prevalence of atherosclerotic changes in patients with calcific AS, suggesting pathogenetic similarities of both disorders. Routine screening of the extracranial cerebral arteries is warranted in all patients with calcific AS and scheduled for valve replacement.


The Journal of Heart Valve Disease 2006;15:165-168
 
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