Background and aims: Valvular atherosclerosis is defined as extra- and intracellular lipid deposition, thickening of the fibrosa layer, decreased thickness of the spongiosa, and chronic inflammation. We sought to identify the predictive factors for valvular atherosclerosis and assess the possible associations between valvular atherosclerosis and coronary atherosclerosis using the Gensini score.
Methods: Between January 2004 and May 2008, 1400 adult patients underwent mitral or aortic valvular surgery with or without coronary artery bypass grafting (CABG) at our center. From the total study population, 68 (4.85%) patients had atherosclerotic valves during histopathological evaluations. Risk factors for valvular atherosclerosis were identified via a comparison between the 68 cases and 115 controls who had valvular surgery without valvular atherosclerotic changes.
Results: Distributions of atherosclerotic changes in the cardiac valves were as follows: 35 (51.5%) patients with aortic atherosclerosis, 27 (39.7%) with mitral atherosclerosis, and 6 (8.8%) with both mitral and aortic valve atherosclerosis. Our univariate analysis revealed that age, gender, diabetes, body mass index (BMI), hyperlipidemia, smoking habit, and aortic stenosis were significant. According to our multivariate analysis, BMI, smoking habit, diabetes, and aortic stenosis were the risk factors for valvular atherosclerosis. Also, stages of coronary artery atherosclerosis using Gensini score were significantly higher in patients with valvular atherosclerosis.
Conclusions: Valvular atherosclerotic changes are strongly analogous with coronary atherosclerosis and generalized atherosclerotic processes. Our results also showed that BMI, smoking habit, diabetes, and aortic stenosis were risk factors for valvular atherosclerosis.