الفهرس 
Aortic Valve SclerosisOnly 14 pages are availabe for public view
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Abstract
many previous studies have included description of calcification or bright echoes, (2) (3) and have reported peak Doppler velocities of < 2.5 meter per second (4), < 2 m/s (3), (4). or < 1.5 m/s (5), however the uses of Doppler velocities in describing aortic sclerosis is not yet universal (6).
In the cardiovascular health study (4) Aortic sclerosis was associated with 35% increase in all-cause mortality (2).
The study included 204 patients with suspected coronary artery disease, referred to Cath–lab in Cardiology Department, Menufia University Hospital for coronary angiography for the evaluation of coronary artery disease between December 2020 and January 2022.
Study included patients with aortic valve sclerosis, (which is defined as a focal increased reflectivity and thickening of the aortic valve cusps noted on echocardiography without evidence of adverse hemodynamic effects). an informed consent was taken , then patients with any of these features were excluded (aortic stenosis, congenital valvular anomalies, advanced other valvular disease, patients with renal failure, and those with poor Echo window). a thorough history was taken from all members of the study group with special emphasis on risk factors for coronary artery disease (Hypertension, diabetes mellitus, smoking, ischemic heart disease, dyslipidemia), family history of premature CAD, then full physical examination and 12 leads ECG.
Summary
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Echocardiography evaluation: Full examination was performed by experienced cardiologist who is blinded to the study, with emphasize on aortic valve leaflets.
Full assessment in 2-D mode and M-mode for chambers and valves then by doppler examination specially for determination of the flow velocity across the aortic valve.
- Two–dimensional echocardiogram from the parasternal long axis (for right and noncoronary cusps) and parasternal short axis for right, left coronary and non-coronary cups.
- Patients with peak velocity more than 200cm/sec. were excluded from our study
- In the short axis view aortic leaflets were examined for amount of calcification, according to Chandra et al., quantified the amount of aortic valve calcification into a scale of 0 to 3.
- Zero grade, Normal leaflet (no involvement); 1, mild (minor involvement of one leaflet); 2, moderate (minor involvement of two leaflets or extensive involvement of one leaflet); and 3, severe (extensive involvement of two leaflets or involvement of all three leaflets).
The study population were divided into 2 groups according to the burden of aortic valve cusp sclerosis
group A, aortic valve sclerosis ≥ 2.
group B aortic valve sclerosis < 2.
We found a significance in-group A for diabetes and smoking with P value <0.007 and 0.03 respectively.
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- LAD affection showed statistically significant difference between the 2 groups, with P value < 0.001
- A relationship between the amount of aortic valve sclerosis with coronary artery disease existence and severity (which was assessed by gensini score) was then established.
- Patients in group A, their mean gensini score was 39.27 with SD 29.51, while in group B mean gensini score was 28.84, and SD was 27.96, the P value was 0.005 which is highly significant.
- The predictive performance of AVS ≥ 2 for gensini score ≥ 34.5, sensitivity was 53.5 %, specificity was 74.7 %, area under ROC is 0.619, with significance of 0.005.
- by multivariate analysis of independent factors for detection of gensini score ≥34.5, LAD affection, and aortic valve sclerosis were the only significant variables among other independent factors, aortic valve sclerosis ≥2 showed P value 0.006 which was very significant as an independent factors for prediction of high gensini score.