Aortic valve sclerosis is a sign of increased arterial stiffness in clinically asymptomatic subjects

Background: Classic risk scores may underestimate the risk of cardiovascular (CV) events in specific risk groups requiring appropriate medical and interventional treatment. Arterial stiffness has been known as a sign of CV risk and has a predictive value for CV events beyond classic CV risk factors. The purpose of this study was to investigate the relation between the cardio-ankle vascular index (CAVI) that has been recently reported as a new surrogate marker of arterial stiffness and aortic valve sclerosis (AVS). Methods: Eighty patients with AVS and 80 control subjects were enrolled to the study. Arterial stiffness was evaluated by VaSera-1000 CAVI instrument and AVS was defined by echocardiography as thickening and calcification of the normal trileaflet aortic valve without obstruction to the left ventricular outflow. Results: CAVI was significantly higher in patients with AVS compared to the control subjects (10.5 +/- 2.7 vs. 8.6 +/- 1.4, p < 0.001). Higher frequency of AVS was detected in patients with abnormal than borderline and normal CAVI values (69% vs. 27% and 20%, respectively, p < 0.001). In univariate analysis, there was a significant association between AVS and CAVI (95% confidence interval [CI] 1.44-2.48, p < 0.001]. Multivariate analysis demonstrated CAVI (95% CI 1.39-2.44, p < 0.001) as an independent determinant of AVS. Conclusions: Detection of increased arterial stiffness could prevent patients from being mistakenly classified as at low or moderate risk, when they actually are at high risk. Assessment of aortic valve during echocardiography examination may offer the opportunity to identify these subjects.