Wilmshurst, P T, Stevenson, R N, Griffiths, H and Lord, John R (1997) A case control investigation of the relation between hyperlipidaemia and calcific aortic valve stenosis. Heart, 78. pp. 475-479. ISSN 1355-6037
|PDF - Published Version |
Objective To investigate the relation of hyperlipidaemia to calcific aortic valve stenosis.
Design A case-control study designed to detect a clinically relevant difference in the fasting plasma concentrations of total cholesterol between the groups at the 5% level with a power of 90%. Predefined subgroup analyses were based on presence of significant coronary disease and valve morphology (that is, bicuspid or tricuspid).
Setting A district general hospital.
Subjects 20 patients with severe calcific aortic stenosis and 20 controls.
Results Mean (SD) fasting plasma total cholesterol in patients with aortic stenosis was 0.79 (1.50) mmol/l greater than in the controls (p = 0.029). The magnitude of differences between patients with aortic stenosis and controls was similar whether the patients had coronary artery disease (0.78 (1.73) mmol/l) or not (0.80 (1.37) mmol/l). The presence of a stenosed tricuspid aortic valve was associated with a significant increase in plasma cholesterol (1.70 (0.87) mmol/l, p = 0.012). For bicuspid valves the degree of elevation of plasma cholesterol was less and not statistically significant.
Conclusions Calcific aortic stenosis is associated with hypercholesterolaemia, especially when the valve is tricuspid. Further studies are necessary to confirm that the relation is causal. This finding may have implications for measures to prevent the most common cause of cardiac valve replacement in the developed world.
|Additional Information:||Reproduced with kind permission from the BMJ Publishing Group|
|Uncontrolled Keywords:||calcific aortic stenosis hypercholesterolaemia hyperlipidaemia|
|Subjects:||R Medicine > RC Internal medicine|
|Schools:||School of Human and Health Sciences|
School of Human and Health Sciences > Centre for Health and Social Care Research
Davies MJ. Pathology of aortic stenosis in the elderly. Cardiol Elderly 1995;3:161-165.
Otto CM, Kuusisto J, Reichenbach DD, Gown AM, O'Brien KD. Characterization of the early lesions of "degenerative" valvular aortic stenosis. Circulation 1994;90:844-853[Abstract/Free Full Text].
Mautner GC, Roberts WC. Reported frequency of coronary arterial narrowing by angiogram in patients with valvular aortic stenosis. Am J Cardiol 1992;70:539-540[Medline].
Peter M, Hoffman A, Parker C, Luscher T, Burckhardt D. Progression of aortic stenosis. Role of age and concomitant coronary artery disease. Chest 1993;103:1715-1719[Abstract/Free Full Text].
Gorlin R, Gorlin G. Hydraulic formula for calculation of area of stenotic mitral valve, other cardiac valves and central circulatory shunts. Am Heart J 1951;41:1-29[Medline].
Mautner GC, Mautner SL, Cannon RO, Hunsberg SA, Roberts WC. Clinical factors useful in predicting aortic valve structure in patients >40 years of age with isolated valvular aortic stenosis. Am J Cardiol 1993;72:194-198[Medline].
Deutscher S, Rockette HE, Krishnaswami V. Diabetes and hypercholesterolaemia among patients with calcific aortic stenosis. J Chron Dis 1984;37:407-415[Medline].
Hoagland PM, Cook EF, Flatley M, Walker C, Goldman L. Case-control analysis of risk factors for presence of aortic stenosis in adults (age 50 years or older). Am J Cardiol 1985;55:744-747[Medline].
Rallidis L, Nihoyannopoulos P, Thompson GR. Aortic stenosis in homozygous familial hypercholesterolaemia. Heart 1996;76:84-85[Free Full Text].
Kannel WB, Castelli WP, Gordon T, McNamara PM. Serum cholesterol, lipoproteins, and the risk of coronary heart disease: the Framingham Study. Ann Intern Med 1971;74:1-12.
Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study. Lancet 1994;344:1383-1389[Medline].
Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, Macfarlane PW, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995;333:1301-1307[Abstract/Free Full Text].
|Depositing User:||John Lord|
|Date Deposited:||13 Jul 2009 11:07|
|Last Modified:||06 Jan 2011 18:18|
Downloader CountriesMore statistics for this item...
Repository Staff Only: item control page