Incidence and Character of Degenerative Afections of the Aortic Valve in the Elderly Population

Overview

By retrospective analysis of all echocardiographically examined subjects above 65 years (separately also > 75 years) during the last three years the authors assessed the incidence of degenerative affections of the aortic valve (Aodeg). It was a selected population with: a) already existing cardiac disease, b) with suspected cardiac disease or c) with examination focused on left ventricular function for various reasons (most frequently preoperative). Inborn and postrheumatic aortic and mitral defects and hypertrofickc cardiomyopathies were not included. The following were considered manifestations of Aodeg: fibrous thickening, calcification, possibly both, affectong the valve or its ring.In the group of 1672 echocardiographically examined subjects who met the defined criteria signs of Aodeg were found in 841, i.e. in 50%, in subjects above 75 years (n = 397) the incidence was for logical reasons somewhat higher, 56%. Fibrosis of the aortic valve was found in 704 of 1672 subjects (42%), calcification in the valve or ring in 137 (8%, 6% in those >65 years and 8% in those >75 years.We conclude tkat degenerative affections of the aortic valve are in a selected cardiological population above 65 years very frequent, they are found in more than half the subjects and do not depend on sex. Contrary to original assumptions Aodeg is more frequently linked with aortic insufificiency (always extremely mild) than stenoses. More than one third of subjects with Aodeg has simultaneously signs a degenerative process and of the mitral valvular apparatus (36%). The combined affection of the aortic and mitral valve is insignificantly more frequent in women (22 vs. 15%). The results are consistent with a Finnish population study of 1993 where degenerativn of the Ao valve with calcifications was found in 53% subjects above 55 years. It is a negative and striking phenomenon tkat degenerative aortic defects are suspected in practice in less than one quarter of cases.

Key words:
aortic valve - degenerative valvular changes - aortic stenosis.