Echocardiographic evaluation of aortic atheromas in patients with aortic stenosis.
OBJECTIVES
The association of aortic atheromas in patients with isolated aortic stenosis has recently been acknowledged, probably because the pathogenic mechanisms are similar. Therefore, this study evaluated the extent and severity of thoracic aortic atheromas in patients with different grades of aortic stenosis using transesophageal echocardiography.


METHODS
We retrospectively evaluated transesophageal echocardiographic examinations of 686 consecutive patients with a diagnosis of aortic stenosis. The prevalence and morphologic characteristics of atheromas in 3 segments of the thoracic aorta were assessed. Plaque thickness was measured at each segment, and the thickest plaque was used to establish severity. Atheromas were graded as mild, moderate, or severe according to plaque thickness (<2, 2-4, or >4 mm, respectively). Aortic stenosis was graded as mild, moderate, or severe on the basis of the gradient and anatomic aortic valve area (>1.5, 1.0-1.5, or <1.0 cm(2)).


RESULTS
A total of 382 patients were men, and 304 were women (mean age ± SD, 74 ± 15 years); 86% of the patients had aortic atheromas. The severe stenosis group had a significantly higher rate of atheromas (95% versus 40%; P < .001) than the mild stenosis group, with more complex atheromas (52% versus 22%; P< .001). There was no significant difference in the atheroma grades between the severe and moderate stenosis groups, but moderate cases had more moderate and severe atheromas than mild cases (45% and 15% versus 19% and 3%; P < .01).


CONCLUSIONS
This study showed a correlation in the extent of aortic atheromas across several degrees of aortic stenosis. Patients with moderate and severe stenosis had more extensive atherosclerotic atheromas than those with mild stenosis.
['Vizzardi|Enrico|E|', "D'Aloia|Antonio|A|", 'Sciatti|Edoardo|E|', 'Bonadei|Ivano|I|', 'Gelsomino|Sandro|S|', 'Lorusso|Roberto|R|', 'Metra|Marco|M|']
D000368:Aged D001011:Aorta D001024:Aortic Valve Stenosis D017548:Echocardiography, Transesophageal D005260:Female D006801:Humans D008297:Male D058226:Plaque, Atherosclerotic D015203:Reproducibility of Results D012189:Retrospective Studies D012720:Severity of Illness Index
aortic atheroma aortic stenosis transesophageal echocardiography atherosclerosis vascular ultrasound