Relation Between Aortic Valve Sclerosis and Ankle–Brachial Index in Participants Clinically Free of Atherosclerotic Vascular Disease

Abstract

Most patients with peripheral arterial disease (PAD) are asymptomatic and have similar vascular morbidity and mortality with patients with symptomatic PAD. Despite being a very highly prevalent disease, physicians underdiagnose and undertreat PAD. A total of 100 participants with aortic valve sclerosis (AVS) and 100 participants without AVS and age-, gender-, and cardiovascular risk factor-matched participants were enrolled. Ankle-brachial index (ABI) and AVS were evaluated by handheld Doppler device and echocardiography, respectively. There was significantly lower ABI in participants with AVS compared with those without AVS (1.04 ± 0.14 v 1.11 ± 0.07, P = .001). There was a negative correlation between ABI and AVS (r = -.29, P < .001). Linear regression analysis demonstrated an independent association between ABI and AVS (95% confidence interval [CI]: -0.91 to -0.27, P < .001) and β-blocker use (95% CI: -0.96 to -0.02, P: .04). Our findings confirm an association between AVS and PAD that may be attributed to shared vascular risk factors.

Aortic and Mitral Calcification Is Marker of Significant Carotid and Limb Atherosclerosis in Patients with First Acute Coronary Syndrome

“…Although multidetector computed tomography, which is the best cardiac imaging modality for assessing calcium score of coronary vessels, appears to be valuable to identify VC, VC can be simply and reliably detected by standard two‐dimensional echocardiography. Furthermore, echocardiography‐derived VC has been associated with increased risk of incident cardiovascular mortality in the population of the Framingham Heart Study and has been proposed as a marker of atherosclerosis, given its high association with aortic, coronary, carotid, and peripheral vascular disease . Therefore, the presence of VC could provide a more comprehensive view of the diffuse atherosclerotic burden compared with the identification of atherosclerosis in a specific arterial site.…”

“…Furthermore, echocardiography-derived VC has been associated with increased risk of incident cardiovascular mortality in the population of the Framingham Heart Study 25 and has been proposed as a marker of atherosclerosis, given its high association with aortic, coronary, carotid, and peripheral vascular disease. [26][27][28][29] Therefore, the presence of VC could provide a more comprehensive view of the diffuse atherosclerotic burden compared with the identification of atherosclerosis in a specific arterial site. So far, secondary prevention of cardiovascular diseases has been guided by the correction of traditional clinical risk factors, namely hypertension, smoking, diabetes mellitus, and hypercholesterolemia.…”

Subclinical Peripheral Arterial Disease and Ankle-Brachial Index

“…1 They investigated the relation between aortic valve sclerosis (AVS) and peripheral arterial disease (PAD) to identify which risk factors are shared and to what extent. They found decreased ankle-brachial ındex (ABI) values in asymptomatic participants with AVS.…”

“…We read the article ''Relation Between Aortic Valve Sclerosis (AVS) and Ankle-Brachial Index (ABI) in Participants Clinically Free of Atherosclerotic Vascular Disease'' by Korkmaz et al with interest. 1 They investigated the relation between aortic valve sclerosis (AVS) and peripheral arterial disease (PAD) to identify which risk factors are shared and to what extent. They found decreased ankle-brachial ındex (ABI) values in asymptomatic participants with AVS.…”

Response to the Letter “Subclinical Peripheral Arterial Disease and Ankle-Brachial Index”

“…4 As for the relation between the ABI and patient characteristics, this was shown in Table 3 of our article. 3 We did not include any biochemical markers other than those we routinely order since our aim was not to identify the predictors of ABI or investigate the relation between ABI and biochemical markers. Our purpose was to increase the awareness during echocardiography examination that the presence of aortic valve sclerosis may be a clue for asymptomatic PAD.…”