Aortic valve disease is the most prevalent valvular heart disease around the world, with degenerative aortic valve disease the most common aetiology in high-income countries. Both degenerative aortic valve disease and coronary artery disease share pathological features. In particular, the early stages of aortic stenosis, referred to as the initiation phase, demonstrate endothelial damage, lipid infiltration and inflammation leading to early valve fibrosis and calcification. It is perhaps therefore not surprising that risk factors for atherosclerosis have also been associated with incident aortic stenosis. Khurrami et al present the results of the Danish cardiovascular screening trials (DANCAVAS I and II).1 They assessed a large cohort of 14 073 healthy men aged 60–74 years old, who were randomly selected from the Danish population. Calcification in the aortic valve and coronary arteries was assessed on non-contrast CT and associations with a variety of cardiovascular risk factors were investigated. In this asymptomatic elderly male population, aortic valve calcification was identified in 58% and coronary artery calcification identified in 83%. This high prevalence of disease is likely due to the age and gender of this cohort, with older patients having higher aortic valve calcium scores. Patients with more cardiovascular risk factors were more likely to have aortic valve calcification and had higher aortic valve calcium scores. In a multivariable analysis which included the presence of severe coronary artery calcification (>400 Agatston units, AU), only age, obesity, history of cerebrovascular disease and serum phosphate …

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心血管危险因素和主动脉瓣钙化：这些关联意味着什么？

主动脉瓣疾病是世界上最普遍的瓣膜性心脏病，退行性主动脉瓣疾病是高收入国家最常见的病因。退行性主动脉瓣疾病和冠状动脉疾病都有共同的病理特征。特别是主动脉瓣狭窄的早期阶段，称为起始阶段，表现出内皮损伤、脂质浸润和炎症，导致早期瓣膜纤维化和钙化。因此，动脉粥样硬化的危险因素也与主动脉瓣狭窄有关也就不足为奇了。Khurrami 等人介绍了丹麦心血管筛查试验（DANCAVAS I 和 II）的结果。1 他们评估了一个由 14 073 名年龄在 60-74 岁之间的健康男性组成的大型队列，这些男性是从丹麦人群中随机挑选出来的。在非对比 CT 上评估主动脉瓣和冠状动脉中的钙化，并研究与各种心血管危险因素的关联。在这个无症状的老年男性人群中，58% 的人发现主动脉瓣钙化，83% 的人发现冠状动脉钙化。这种疾病的高患病率可能是由于该队列的年龄和性别，老年患者的主动脉瓣钙评分较高。具有更多心血管危险因素的患者更容易发生主动脉瓣钙化，并且主动脉瓣钙化评分更高。在一项多变量分析中，包括严重的冠状动脉钙化（>400 Agatston 单位，AU）、仅年龄、肥胖、脑血管疾病史和血清磷酸盐…… 在这个无症状的老年男性人群中，58% 的人发现主动脉瓣钙化，83% 的人发现冠状动脉钙化。这种疾病的高患病率可能是由于该队列的年龄和性别，老年患者的主动脉瓣钙评分较高。具有更多心血管危险因素的患者更容易发生主动脉瓣钙化，并且主动脉瓣钙化评分更高。在一项多变量分析中，包括严重的冠状动脉钙化（>400 Agatston 单位，AU）、仅年龄、肥胖、脑血管疾病史和血清磷酸盐…… 在这个无症状的老年男性人群中，58% 的人发现主动脉瓣钙化，83% 的人发现冠状动脉钙化。这种疾病的高患病率可能是由于该队列的年龄和性别，老年患者的主动脉瓣钙评分较高。具有更多心血管危险因素的患者更容易发生主动脉瓣钙化，并且主动脉瓣钙化评分更高。在一项多变量分析中，包括严重的冠状动脉钙化（>400 Agatston 单位，AU）、仅年龄、肥胖、脑血管疾病史和血清磷酸盐…… 老年患者的主动脉瓣钙评分较高。具有更多心血管危险因素的患者更容易发生主动脉瓣钙化，并且主动脉瓣钙化评分更高。在一项多变量分析中，包括严重的冠状动脉钙化（>400 Agatston 单位，AU）、仅年龄、肥胖、脑血管疾病史和血清磷酸盐…… 老年患者的主动脉瓣钙评分较高。具有更多心血管危险因素的患者更容易发生主动脉瓣钙化，并且主动脉瓣钙化评分更高。在一项多变量分析中，包括严重的冠状动脉钙化（>400 Agatston 单位，AU）、仅年龄、肥胖、脑血管疾病史和血清磷酸盐……