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Despite improvements in risk scoring assessment of CAD, patients at low risk still experience CHD events.
Aim of study
To evaluate whether the severity of aortic valve sclerosis without mitral annular calcification could be a predictor for the extent of coronary artery disease in patients ≤ 65 years.
Patients and Methods
Fifty patients less than 65 years old without aortic stenosis or bicuspid aortic valve or rheumatic heart or HCM or renal failure were referred for coronary angiography between January 2015 and April 2017. The study subjects were divided into Group I - 20 patients with normal aortic andmitral valves, and Group II - 30 patients with aortic valve sclerosis without mitral annulus calcification.
Patients were subjected to TTE where AVS was defined as a focal area of increased echogenicity and thickening of the aortic valve leaflets without restriction of leaflet motion and a transaortic flow velocity (<2.5 m.s). The thickness was determined from the end diastolic frozen echo images obtained in short or long axis. CAD was graded using coronary catheterizations according to Friesinger score, which ranges from 0 to 15, each of the three main coronary arteries is scored separately from 0 to 5. Score 0: No arteriographic abnormality, Score 1: Trivial irregularities (lesion from 1-29%), Score 2: Localized 30-68% luminal narrowing, Score 3: Multiple 30-68% luminal narrowing of same vessel, Score 4: 69-100% luminal narrowing without 100% occlusion of proximal segments, and Score 5: Total obstruction of a proximal segment of a vessel.
Friesinger score was significantly higher in the sclerotic group (7.30 ± 2.87) compared to the normal group (2.50 ± 2.21) (P < 0.001) linking AVS to CAD.
AVS is strongly interrelated to the extent and severity of coronary atherosclerosis.