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.