Aa
Aortic Stenosis
Is Mild Aortic Stenosis always and inidcator for CAD. Also can this condition be reversed with treatment of high cholesterol levels or does it naturally just progress. Also is there a level of error related to this specific reading on echo either due to technician or reader of report. Sorry, not Stenosis. Meant mild Aortic SCLEROSIS.
continued
There has been a recent study that also demonstrated that the presence of aortic valve sclerosis predicted the presence of coronary artery calcification. This finding was presented at the annual meeting of the American College of Chest Physicians. What they found was that the presence of aortic valve calcification increased the likelihood of having significant coronary artery calcification, which is a marker for coronary atherosclerosis.
This recent finding should not raise undue concern among the many patients who previously felt that they were well and told that their ultrasounds were unremarkable. However, we do believe this finding does signal an increased risk and should create a heightened awareness of the possibility of associated cardiovascular disease. There is no specific treatment for aortic valve sclerosis at this time, although there are studies ongoing to determine whether lipid-lowering or cholesterol-lowering medications may reduce the degree of calcification.
Taking all of this into consideration, our recommendations would be as follows:
1) Aortic valve sclerosis represents increased risk for cardiovascular disease, including coronary artery disease. This is especially true when it is detected in patients less than 65 years of age.
2) This finding should provide impetus for progressive risk factor management, including better control of hypertension, as well as aggressive treatment of elevated cholesterol.
3) Consideration should be given to an exercise treadmill test when aortic valve sclerosis is detected.
4) If the calcium deposits are significant, and the murmur is quite prominent, there may be an indication for what is known as endocarditis prophylaxis. This is simply the need for antibiotic medication prior to surgical or dental procedures.
In conclusion, I agree with the statement by Dr. Carabello of the Houston Veterans Affairs Medical Center when he said that aortic valve sclerosis should be viewed “as a harbinger of future events”.
Sacramento Heart and Vascular (no associated date)
http://www.sacheart.com/articles/article11.html
-------------------------
Kitzman and fellow researchers evaluated data from the Cardiovascular Health Study, which involved almost 6,000 older adults in Forsyth County and three other communities. The participants in this observational study had echocardiograms -- ultrasound tests of the heart -- when the study began in 1989.
Even after adjusting for other factors that could increase risk, such as age, high blood pressure, high cholesterol, and smoking, the researchers found that in people with no signs of heart disease when the study began, those with aortic sclerosis had a 50 percent greater chance of dying from heart-related causes than those without it.
For participants who had known heart disease when the study began, having aortic sclerosis increased their risk of dying from heart-related causes by 20 percent.
Wake Forest University Baptist Medical Center, 1999
http://www.scienceblog.com/community/older/1999/E/199904587.html
There has been a recent study that also demonstrated that the presence of aortic valve sclerosis predicted the presence of coronary artery calcification. This finding was presented at the annual meeting of the American College of Chest Physicians. What they found was that the presence of aortic valve calcification increased the likelihood of having significant coronary artery calcification, which is a marker for coronary atherosclerosis.
This recent finding should not raise undue concern among the many patients who previously felt that they were well and told that their ultrasounds were unremarkable. However, we do believe this finding does signal an increased risk and should create a heightened awareness of the possibility of associated cardiovascular disease. There is no specific treatment for aortic valve sclerosis at this time, although there are studies ongoing to determine whether lipid-lowering or cholesterol-lowering medications may reduce the degree of calcification.
Taking all of this into consideration, our recommendations would be as follows:
1) Aortic valve sclerosis represents increased risk for cardiovascular disease, including coronary artery disease. This is especially true when it is detected in patients less than 65 years of age.
2) This finding should provide impetus for progressive risk factor management, including better control of hypertension, as well as aggressive treatment of elevated cholesterol.
3) Consideration should be given to an exercise treadmill test when aortic valve sclerosis is detected.
4) If the calcium deposits are significant, and the murmur is quite prominent, there may be an indication for what is known as endocarditis prophylaxis. This is simply the need for antibiotic medication prior to surgical or dental procedures.
In conclusion, I agree with the statement by Dr. Carabello of the Houston Veterans Affairs Medical Center when he said that aortic valve sclerosis should be viewed “as a harbinger of future events”.
Sacramento Heart and Vascular (no associated date)
http://www.sacheart.com/articles/article11.html
-------------------------
Kitzman and fellow researchers evaluated data from the Cardiovascular Health Study, which involved almost 6,000 older adults in Forsyth County and three other communities. The participants in this observational study had echocardiograms -- ultrasound tests of the heart -- when the study began in 1989.
Even after adjusting for other factors that could increase risk, such as age, high blood pressure, high cholesterol, and smoking, the researchers found that in people with no signs of heart disease when the study began, those with aortic sclerosis had a 50 percent greater chance of dying from heart-related causes than those without it.
For participants who had known heart disease when the study began, having aortic sclerosis increased their risk of dying from heart-related causes by 20 percent.
Wake Forest University Baptist Medical Center, 1999
http://www.scienceblog.com/community/older/1999/E/199904587.html
Pulzie, I have mild aortic sclerosis and aggressive CAD. I have 6 stents and am waiting for bypass surgery. I did a lot of research yesterday on a reply for you, since this subject is so near and dear to my heart....I just didn't get to post it. I had a heart attack and stroke in June of 2003. Since then I have spent a lot of time researching heart/valve disease.
I also have extremely high cholesterol and triglyceride levels, due to hyperlipidemia (an inherited condition), and have not been able to tolerate statins until recently. I am taking 20 mg of Lipitor daily and it may be my imagination, but I think I can tell it is working. I can't wait to see my test results today.
I will post excerpts below and links to info on aortic sclerosis, which only means a calcium buildup on the aortic valve. When the arteries have calcium and damage, it is call arteriosclerosis, or hardening of the arteries which is a natural aging process. Trouble is, when you are < 60 or so, it is a real sign of morbidity and mortality.
The degree of calcium and it's affect on the functioning of the aortic valve is what distinguishes sclerosis from stenosis. Stenosis can cause the opening of the aortic valve to become smaller and "more stiff". This can lead to many serious conditions such as heart attack and stroke. The aortic valve has to open in order for fresh oxygenated blood to reach our organs including the coronary arteries that supply the muscle of the heart. Blood to our coronary arteries/heart only flows when are heart is in the diastolic or resting phase. So, you can see that a smaller opening in our aortic valve would impede flow to our hearts, due to the blood being at less pressure. (diastolic versus systolic). This is how it can cause a heart attack.
I have read that some statins, maybe any that work for you, can reverse this otherwise progressive condition. Sclerosis does not always progress to stenosis, I guess because people find out about the sclerosis and change their lifestyle and lower their cholesterol by use of statins if needed. I think this is mentioned below. I know that I read of it yesterday. Some unfortunate people that I know have waited until their aortic valve is stenotic and must be replaced.
Per my research, aortic sclerosis is an indicator of CAD in many cases. Sorry about that. Clinical test have shown why aortic sclerosis is associated with a high rate of mortality. The answer is CAD. It is discussed below.
Echocardiograms are interpreted by doctors, so the interpretation is subjective. Some doctors have better skills compared to others in interpreting the results of an echocardiogram. Some doctors specialize in interpreting echocardiograms. I have seen this difference in ability through first hand experience, or either I have a rapidly changing heart!
The lab equipment can be obsolete, or at least out of date/not calibrated correctly, especially for M mode (single dimension). The tech that performs the echo can make mistakes. As you know, they locate areas of the heart and "click with a mouse to mark" one boundary of say the LV posterior wall and then click the mouse to mark the other boundary or side of the LV posterior wall. I have seen some in a real hurry, like they are trying to impress you. That makes me get the feeling that they are unprofessional with such an extremely important test. This is to me the very best cardiovascular test for the money, if given and interpreted correctly.
So I would most definitely say that there is a possible level of error with these tests.
Best of luck and I hope the below info does not overwhelm you.
Jack
--------------------------------------------------------------------------------------
2004 The Journal of the American College of Cardiology, data from the Division of Cardiology, Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA
"Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation."
OBJECTIVES: The present study was designed to evaluate the relationship between the presence of aortic sclerosis, serologic markers of inflammation, and adverse cardiovascular outcomes.
BACKGROUND: Aortic sclerosis is associated with adverse cardiovascular outcomes. However, the mechanism by which such nonobstructive valve lesions impart excess cardiovascular risk has not been delineated.
CONCLUSIONS: The increased incidence of adverse cardiovascular events in patients with aortic sclerosis is associated with coronary artery disease and inflammation, not a result of the effects of valvular heart disease per se.
It is associated with an increase of approximately 50% in the risk of death from cardiovascular causes and the risk of myocardial infarction. The mechanism by which aortic sclerosis contributes to or is associated with increased cardiovascular risk is not known. Aortic sclerosis is associated with systemic endothelial dysfunction, and a small percentage of cases may progress to aortic stenosis.
Lowering of LDL cholesterol by 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors have been shown to decrease progression of aortic valve calcification. Aortic sclerosis is not a mere benign finding. Once diagnosis of aortic sclerosis has been made, it should be considered a potential marker of coexisting coronary disease. Aggressive management of modifiable risk factors, especially LDL cholesterol lowering, may slow progression of the disease.
Albert Einstein College of Medicine, Dec, 2004
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=15628107
------------------------
I also have extremely high cholesterol and triglyceride levels, due to hyperlipidemia (an inherited condition), and have not been able to tolerate statins until recently. I am taking 20 mg of Lipitor daily and it may be my imagination, but I think I can tell it is working. I can't wait to see my test results today.
I will post excerpts below and links to info on aortic sclerosis, which only means a calcium buildup on the aortic valve. When the arteries have calcium and damage, it is call arteriosclerosis, or hardening of the arteries which is a natural aging process. Trouble is, when you are < 60 or so, it is a real sign of morbidity and mortality.
The degree of calcium and it's affect on the functioning of the aortic valve is what distinguishes sclerosis from stenosis. Stenosis can cause the opening of the aortic valve to become smaller and "more stiff". This can lead to many serious conditions such as heart attack and stroke. The aortic valve has to open in order for fresh oxygenated blood to reach our organs including the coronary arteries that supply the muscle of the heart. Blood to our coronary arteries/heart only flows when are heart is in the diastolic or resting phase. So, you can see that a smaller opening in our aortic valve would impede flow to our hearts, due to the blood being at less pressure. (diastolic versus systolic). This is how it can cause a heart attack.
I have read that some statins, maybe any that work for you, can reverse this otherwise progressive condition. Sclerosis does not always progress to stenosis, I guess because people find out about the sclerosis and change their lifestyle and lower their cholesterol by use of statins if needed. I think this is mentioned below. I know that I read of it yesterday. Some unfortunate people that I know have waited until their aortic valve is stenotic and must be replaced.
Per my research, aortic sclerosis is an indicator of CAD in many cases. Sorry about that. Clinical test have shown why aortic sclerosis is associated with a high rate of mortality. The answer is CAD. It is discussed below.
Echocardiograms are interpreted by doctors, so the interpretation is subjective. Some doctors have better skills compared to others in interpreting the results of an echocardiogram. Some doctors specialize in interpreting echocardiograms. I have seen this difference in ability through first hand experience, or either I have a rapidly changing heart!
The lab equipment can be obsolete, or at least out of date/not calibrated correctly, especially for M mode (single dimension). The tech that performs the echo can make mistakes. As you know, they locate areas of the heart and "click with a mouse to mark" one boundary of say the LV posterior wall and then click the mouse to mark the other boundary or side of the LV posterior wall. I have seen some in a real hurry, like they are trying to impress you. That makes me get the feeling that they are unprofessional with such an extremely important test. This is to me the very best cardiovascular test for the money, if given and interpreted correctly.
So I would most definitely say that there is a possible level of error with these tests.
Best of luck and I hope the below info does not overwhelm you.
Jack
--------------------------------------------------------------------------------------
2004 The Journal of the American College of Cardiology, data from the Division of Cardiology, Department of Internal Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA
"Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation."
OBJECTIVES: The present study was designed to evaluate the relationship between the presence of aortic sclerosis, serologic markers of inflammation, and adverse cardiovascular outcomes.
BACKGROUND: Aortic sclerosis is associated with adverse cardiovascular outcomes. However, the mechanism by which such nonobstructive valve lesions impart excess cardiovascular risk has not been delineated.
CONCLUSIONS: The increased incidence of adverse cardiovascular events in patients with aortic sclerosis is associated with coronary artery disease and inflammation, not a result of the effects of valvular heart disease per se.
It is associated with an increase of approximately 50% in the risk of death from cardiovascular causes and the risk of myocardial infarction. The mechanism by which aortic sclerosis contributes to or is associated with increased cardiovascular risk is not known. Aortic sclerosis is associated with systemic endothelial dysfunction, and a small percentage of cases may progress to aortic stenosis.
Lowering of LDL cholesterol by 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors have been shown to decrease progression of aortic valve calcification. Aortic sclerosis is not a mere benign finding. Once diagnosis of aortic sclerosis has been made, it should be considered a potential marker of coexisting coronary disease. Aggressive management of modifiable risk factors, especially LDL cholesterol lowering, may slow progression of the disease.
Albert Einstein College of Medicine, Dec, 2004
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=15628107
------------------------
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