Background: Atherosclerotic risk factors have been associated with aortic stenosis (AS) and aortic sclerosis (ASc). ASc is characterized by thickening of the aortic cusps with no significant obstruction of left ventricular outflow. ASc has been regarded as a precursor of hemodynamically significant AS. Both are associated with increased risk of cardiovascular morbidity and mortality.
Objective: to evaluate the difference in the prevalence of cardiovascular risk factors, laboratory features and echocardiographic parameters among patients with ASc and patients with moderate to severe AS.
Methods: An observational study comparing 210 consecutive patients with ASc (age 77±8) and 190 patients with AS (age 78±7). Cardiovascular risk factors, laboratory data including serum biochemistry and differential blood counts and echocardiographic measurements were compared.
Results: the prevalence of hypertension, hypercholesterolemia and smoking as well as the presence of ischemic heart disease were not significantly different between the groups. However, male gender and diabetes were significantly higher in the ASc group than in patients with AS (p=0.002, p=0.014 respectively). Creatinine levels were higher in the ASc group (1.21±1 mg/dl vs.1.03±0.4 mg/dl, p=0.02). Patients with AS had higher ejection fraction (55±7% vs 53±8% P=0.05), smaller Left Ventricular End Systolic Dimension (LVESD), more Left Ventricular Hypertrophy (LVH) and larger aortic root diameter (p=0.08, 0.009, 0.001 respectively).
Conclusions: Differences observed in clinical and laboratory findings between patients with AS and ASc suggest that differential pathophysiologic mechanisms underlie both conditions. Further insight into this observation may aid in planning prevention and treatment measures for these patients.
