Relationship Between Silent Myocardial Ischemia and Aortic Valve Sclerosis in Patients with Essential Hypertension

Objectives: Silent. myocardial ischemia has been observed in hypertensive patients with a prevalence of 35-45%. Recently, aortic valve sclerosis has been identified as a manifestation of atherosclerotic process. The aim of our study was to investigate the association between silent ischemia, aortic valve sclerosis, and some other echocardiographic and laboratory parameters in a group of asymptomatic hypertensive individuals. Methods: The study group consisted of 131 consecutive hypertensive patients without any complaint of angina pectoris or congestive heart failure. Presence of silent ischemia was detected with T l 20 ı myocardial perfusion scintigraphy. In echocardiographic examination left ventricular geometry, systolic and diastolic function and valvular involvement were assessed. Severity of aortic valve seleresis was graded between O to 3 degrees. Results: Silent ischemia was detected in 46 patients (35%). They were significantly older, had a higher frequency of male gender and higher lipoprotein (a) levels than patients without ischemia (age: 6 ı ±9 years vs. 56±9 years; male gender: 57% vs. 35%, p=0.02; lipoprotein (a): 53±43 mg/di vs. 36±32 mg/di, p=O.O ı). Left ventricular mass, systolic and diastolic function did not differ between both groups. Silent ischemia was significantly correlated with the presence of aortic valve seleresis (r=0.27, pConclusion: In patients with essential hypertension, silent myocardial ischemia is significantly associated with aortic valve sclerosis. This finding suggests that echocardiographic determination of aortic valve sclerosis may be used as a preliminary diagnostic marker for coronary atheroselerosis in these patients.

Keywords: Echocardiography, hypertension, aortic valve, atherosclerosis