PREVALENCE OF AORTIC-VALVE ABNORMALITIES IN THE ELDERLY - AN ECHOCARDIOGRAPHIC STUDY OF A RANDOM-POPULATION SAMPLE
PREVALENCE OF AORTIC-VALVE ABNORMALITIES IN THE ELDERLY - AN ECHOCARDIOGRAPHIC STUDY OF A RANDOM-POPULATION SAMPLE
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DOI：
10.1016/0735-1097(93)90249-z
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发表时间：
1993-04-01
影响因子：
24
通讯作者：
TILVIS, R
中科院分区：
文献类型：
--
作者：
LINDROOS, M;KUPARI, M;TILVIS, R
目标。这项研究是为了阐明老年人主动脉瓣异常的发生率。积极接受瓣膜疾病治疗的人的年龄正在增加。需要更多关于老年人主动脉瓣疾病患病率的信息。随机选择参与赫尔辛基老龄化研究的75~76岁、80~81岁和85~86岁年龄组(n=501)的男性和女性进行超声心动图检查。此外，还包括年龄在55岁至71岁之间的76人。根据连续性方程计算收缩期主动脉瓣面积。血流速度比(左心室流出道峰值速度/跨主动脉瓣峰值速度)可作为判断主动脉狭窄的辅助指标。对瓣膜返流及瓣膜尖端钙化情况进行直观评价。有552人(96%)可以对主动脉瓣进行评估。轻度钙化222例(40%)，重度钙化72例(13%)。2人(0.4%)接受了主动脉瓣假体手术。12例(2.2%)存在严重的先天性瓣膜狭窄(计算的主动脉瓣面积小于或等于0.8cm2，血流速度比小于或等于0.35)。其中6人有症状，有可能接受瓣膜手术。主动脉瓣狭窄患者年龄最大的三个年龄段。在75-86岁年龄组中，临界主动脉瓣狭窄的患病率为2.9%(95%可信区间为1.4%~5.1%)。在整个研究队列中，29%的人发现了主动脉瓣返流，大多是轻微的。钙化性主动脉瓣狭窄是老年人的一个重大健康问题。只有少数潜在可手术的主动脉瓣狭窄患者接受了手术。
Objectives. This study was undertaken to elucidate the prevalence of aortic valve abnormalities in the elderly.Background. The age of persons treated actively for valve disorders is increasing. More information is needed about the prevalence of aortic valve disease in old age.Methods. Randomly selected men and women in the age groups 75 to 76, 80 to 81 and 85 to 86 years (n = 501) participating in the Helsinki Ageing Study were studied with imaging and Doppler echocardiography. Additionally, 76 persons 55 to 71 years of age were included. The systolic aortic valve area was calculated by the continuity equation. The velocity ratio (peak velocity in the left ventricular outflow tract/peak velocity across the aortic valve) was a supplementary criterion for aortic stenosis. Valve regurgitation and cusp calcification were assessed visually.Results. Evaluation of the aortic valve was possible in 552 persons (96%). Mild calcification was found in 222 (40%) and severe calcification in 72 (13%). Two persons (0.4%) had an aortic valve prosthesis. Critical native valve stenosis (calculated aortic valve area less-than-or-equal-to 0.8 cm2 and velocity ratio less-than-or-equal-to 0.35) was found in 12 persons (2.2%). Six of these were symptomatic and potentially eligible for valvular surgery. AH persons with aortic valve stenosis were in the three oldest age groups. The prevalence of critical aortic valve stenosis was 2.9% (95% confidence interval 1.4% to 5.1%) in the group 75 to 86 years of age. Aortic regurgitation, mostly mild, was found in 29% of the entire study cohort.Conclusions. Calcific aortic valve stenosis constitutes a significant health problem in the elderly. Only a minority of those with potentially operable aortic valve stenosis undergo surgery.