A Case-Control Study On Risk Factors Of Senile Calcific Heart Valvular Disease And Relationship Between Valve Calcification And Carotid Atherosclerosis

Objective: To evaluate the risk factors, characteristics of echocardiogram of senile calcific heart valvular disease, and the relationship between valve calcification and carotid atherosclerosis.Method: The method case-control study was used to analyse 294 hospitalized patients from may, 2006 to August, 2007 eligible to be included in this study acoording to the given criteria. These subjects were divided into two groups according to echocardiogram results: calcified valve group(n=147) and control group(n=147). The detailed data of the patients involved were collected and evaluated by univariate and multivariate Logistic regression analyse. Finally, The relationship between valve calcification and carotid atherosclerosis was analysed by Logistic regression and measuring IMT by method ANOVA.Results:1. Univariate analyse showed that hyperlipidemia(P=0.004), hypertension (P=0.014), smoking(P=0.003), history of TIA/stroke(P=0.027), cardiac enlargement (P=0.043), serum level of total cholesterol (P=0.028), and serum level of LDL-C(P=0.029) were significantly different in the presence of calcified valves. The results of mutivariate Logistic regression analyse showed: the OR(95% confidence interval) for valve calcification was 1.317(1.082—1.603)for elevating every one grade of hypertension, 1.928(1.139—3.266)for the presence of smoking, and 1.938(1.137—3.302)for 1mmol/L increase in serum concentration of LDL-C.2. Simple aortic valve calcifications were found in 117 cases (79.6%), simple mitral valve calcification in 6 cases(4.1% ), and aortic valve calcification combined with mitral valve calcification in 24 cases (16.3%);There were 42 cases(28.6%) with aortic regurgitation, which was the highest morbidity in cardiac valve dysfunction within the 91 cases, 27 cases (18.4%) with aortic stenosis, the second, and 1 case(0.7%) with mitral regurgitation combined with stenosis, the lowest.3. Among the 173 cases with detailed carotid echocardiogram information, 40 cases were classified calcified valve group, 133 cases control group. There were 6 cases having carotid stenosis in calcified valve group, 17 cases in control group, but no significant diference of morbidity was showed between the two groups(χ2=0.131,P=0.717). The valve calcification was positively associated with carotid atherosclerosis (P=0.009). The IMT was significantly different between calcified valve group and control group(P=0.043). Conclusion: Hypertension, smoking, and hyperlipidemia (especially high level of LDL-C) increase the likelihood risk of senile calcific heart valvular disease. The senile calcific heart valvular disease mainly damages aortic or mitral valve, the lesion types of which include stenosis and regurgitation. Echocardiography is the main tool that has clinical significance for the diagnosis of senile calcific heart valvular diease. The valve calcification has a positive association with carotid atherosclerotic disease, and it may be one of the predictors of atherosclerosis.