Sep. 7, 2001 ROCHESTER, MINN. -- Standard echocardiograms which image the heart using ultrasound waves -- much like the ultrasound images used during pregnancy to monitor fetal development -- can be used as a screening tool to spot aortic valve abnormalities and to identify people at high risk for stroke and heart valve disease, according to a Mayo Clinic study published in September's Journal of the American College of Cardiology.
"Everyone who is obese or has high blood pressure should take action to reduce those risk factors, but the echocardiogram now gives us more information about who is most at risk and who should be most urgently concerned," says Bijoy Khandheria, M.D., a Mayo Clinic cardiologist and study author.
The study examined a sample of 581 Olmsted County, Minn., residents using both standard and transesophageal echocardiography (TEE). TEE involves inserting an ultrasound probe down the throat to view portions of the heart and aorta that cannot be seen in a conventional echocardiogram taken through the chest wall. Researchers found that more than one-third of the volunteers ages 45 and older had plaque buildup on their aortic valves, and that there was a strong correlation between this aortic valve sclerosis and hardening and narrowing of the aorta.
"This study demonstrates for the first time that aortic valve sclerosis and atherosclerosis are not two different diseases, but rather different manifestations of the same disease process," says Dr. Khandheria. "Therefore, if we can determine through a standard echocardiogram that the aortic valve is becoming stiff, it is highly likely there are plaques in the aorta and coronary blood vessels as well."
Researchers found that male gender, high blood pressure, obesity and elevated levels of the protein homocysteine significantly increased the likelihood of plaques forming in the aorta and on the aortic valve. Those risk factors point out people who would benefit from an echocardiographic screening. They also suggest lifestyle changes that would help prevent life-threatening complications.
Dr. Khandheria says men over 40 years old who are more than 25 pounds overweight, as defined by a Body Mass Index (BMI) of 30 or higher, should have a screening echo. Women who are obese should have the test done after age 50. A BMI calculator is available on MayoClinic.com, Mayo Clinic's health information web site, at http://mayoclinic.com/home?id=DS00314.
"Patients whose echocardiograms show aortic valve sclerosis are at high risk for stroke and for narrowing of the aortic valve, or stenosis, which can necessitate valve surgery," says
Dr. Khandheria. "They're also likely to have coronary artery disease. By helping them work to lose weight and get their blood pressure under control, we can hopefully stop or significantly slow the process of disease."
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