FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 341:142-147 July 15, 1999 Number 3 Next

	Full Text PDF Editorial by Carabello, B. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Although aortic-valve stenosis is clearly associated with adverse cardiovascular outcomes, it is unclear whether valve sclerosis increases the risk of cardiovascular events.

Methods We assessed echocardiograms obtained at base line from 5621 men and women 65 years of age or older who were enrolled in a population-based prospective study. On echocardiography, the aortic valve was normal in 70 percent (3919 subjects), sclerotic without outflow obstruction in 29 percent (1610), and stenotic in 2 percent (92). The subjects were followed for a mean of 5.0 years to assess the risk of death from any cause and of death from cardiovascular causes. Cardiovascular morbidity was defined as new episodes of myocardial infarction, angina pectoris, congestive heart failure, or stroke.

Results There was a stepwise increase in deaths from any cause (P for trend, <0.001) and deaths from cardiovascular causes (P for trend, <0.001) with increasing aortic-valve abnormality; the respective rates were 14.9 and 6.1 percent in the group with normal aortic valves, 21.9 and 10.1 percent in the group with aortic sclerosis, and 41.3 and 19.6 percent in the group with aortic stenosis. The relative risk of death from cardiovascular causes among subjects without coronary heart disease at base line was 1.66 (95 percent confidence interval, 1.23 to 2.23) for those with sclerotic valves as compared with those with normal valves, after adjustment for age and sex. The relative risk remained elevated after further adjustment for clinical factors associated with sclerosis (relative risk, 1.52; 95 percent confidence interval, 1.12 to 2.05). The relative risk of myocardial infarction was 1.40 (95 percent confidence interval, 1.07 to 1.83) among subjects with aortic sclerosis, as compared with those with normal aortic valves.

Conclusions Aortic sclerosis is common in the elderly and is associated with an increase of approximately 50 percent in the risk of death from cardiovascular causes and the risk of myocardial infarction, even in the absence of hemodynamically significant obstruction of left ventricular outflow.

Source Information

From the Departments of Medicine (C.M.O., D.S.S.), Biostatistics (B.K.L.), and Epidemiology (D.S.S.) and the Cardiovascular Health Research Unit (D.S.S.), University of Washington, Seattle; the Division of Cardiology, Wake Forest University School of Medicine, Winston-Salem, N.C. (D.W.K.); and the Division of Cardiology, Mayo Clinic, Rochester, Minn. (B.J.G.).

Address reprint requests to Dr. Otto at the Division of Cardiology, Box 356422, University of Washington, Seattle, WA 98195-6422.

Full Text of this Article

Related Letters:

Aortic-Valve Sclerosis
Getchell W. S., Kim D. K., Rajput V., Achuff S. C., Baumgartner W. A., Otto C. M., Siscovick D. S.
Extract | Full Text  
N Engl J Med 1999; 341:1856-1857, Dec 9, 1999. Correspondence

This article has been cited by other articles:

• Rossebo, A. B., Pedersen, T. R., Boman, K., Brudi, P., Chambers, J. B., Egstrup, K., Gerdts, E., Gohlke-Barwolf, C., Holme, I., Kesaniemi, Y. A., Malbecq, W., Nienaber, C. A., Ray, S., Skjaerpe, T., Wachtell, K., Willenheimer, R., the SEAS Investigators, (2008). Intensive Lipid Lowering with Simvastatin and Ezetimibe in Aortic Stenosis. NEJM 0: NEJMoa0804602v1-1 [Abstract] [Full Text]  
• Rajamannan, N. M (2008). Low-density lipoprotein and aortic stenosis. Heart 94: 1111-1112 [Full Text]  
• Carabello, B. A. (2008). Aortic Stenosis: It Is a Hot Topic: The Link to Coronary Artery Disease. J Am Coll Cardiol 52: 764-766 [Full Text]  
• Babu, A. N., Meng, X., Zou, N., Yang, X., Wang, M., Song, Y., Cleveland, J. C., Weyant, M., Banerjee, A., Fullerton, D. A. (2008). Lipopolysaccharide stimulation of human aortic valve interstitial cells activates inflammation and osteogenesis.. Ann. Thorac. Surg. 86: 71-76 [Abstract] [Full Text]  
• Rajamannan, N. M. (2008). Update on the pathophysiology of aortic stenosis. Eur Heart J Suppl 10: E4-E10 [Abstract] [Full Text]  
• Owens, D. S., Katz, R., Johnson, E., Shavelle, D. M., Probstfield, J. L., Takasu, J., Crouse, J. R., Carr, J. J., Kronmal, R., Budoff, M. J., O'Brien, K. D. (2008). Interaction of Age With Lipoproteins as Predictors of Aortic Valve Calcification in the Multi-Ethnic Study of Atherosclerosis. Arch Intern Med 168: 1200-1207 [Abstract] [Full Text]  
• Salem, D. N., O'Gara, P. T., Madias, C., Pauker, S. G. (2008). Valvular and Structural Heart Disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133: 593S-629S [Abstract] [Full Text]  
• Hinton, R. B. Jr., Alfieri, C. M., Witt, S. A., Glascock, B. J., Khoury, P. R., Benson, D. W., Yutzey, K. E. (2008). Mouse heart valve structure and function: echocardiographic and morphometric analyses from the fetus through the aged adult. Am. J. Physiol. Heart Circ. Physiol. 294: H2480-H2488 [Abstract] [Full Text]  
• Ryan, R., Abbara, S., Colen, R. R., Arnous, S., Quinn, M., Cury, R. C., Dodd, J. D. (2008). Cardiac Valve Disease: Spectrum of Findings on Cardiac 64-MDCT. Am. J. Roentgenol. 190: W294-W303 [Abstract] [Full Text]  
• Bosse, Y., Mathieu, P., Pibarot, P. (2008). Genomics: The Next Step to Elucidate the Etiology of Calcific Aortic Valve Stenosis. J Am Coll Cardiol 51: 1327-1336 [Abstract] [Full Text]  
• Pho, M., Lee, W., Watt, D. R., Laschinger, C., Simmons, C. A., McCulloch, C. A. (2008). Cofilin is a marker of myofibroblast differentiation in cells from porcine aortic cardiac valves. Am. J. Physiol. Heart Circ. Physiol. 294: H1767-H1778 [Abstract] [Full Text]  
• Mittnacht, A. J., Fanshawe, M., Konstadt, S. (2008). Anesthetic Considerations in the Patient With Valvular Heart Disease Undergoing Noncardiac Surgery. SEMIN CARDIOTHORAC VASC ANESTH 12: 33-59 [Abstract]  
• Donnelly, K. B. (2008). Cardiac Valvular Pathology: Comparative Pathology and Animal Models of Acquired Cardiac Valvular Diseases. Toxicol Pathol 36: 204-217 [Abstract] [Full Text]  
• Goland, S., Trento, A., Czer, L. S.C., Eshaghian, S., Tolstrup, K., Naqvi, T. Z., De Robertis, M. A., Mirocha, J., Iida, K., Siegel, R. J. (2008). Thoracic Aortic Arteriosclerosis in Patients With Degenerative Aortic Stenosis With and Without Coexisting Coronary Artery Disease. Ann. Thorac. Surg. 85: 113-119 [Abstract] [Full Text]  
• Padera, R. F. Jr., Schoen, F. J. (2008). Pathology of Cardiac Surgery. Card Surg Adult 3: 111-178 [Full Text]  
• Mihaljevic, T., Sayeed, M. R., Stamou, S. C., Paul, S. (2008). Pathophysiology of Aortic Valve Disease. Card Surg Adult 3: 825-840 [Full Text]  
• Peltonen, T. O., Taskinen, P., Soini, Y., Rysa, J., Ronkainen, J., Ohtonen, P., Satta, J., Juvonen, T., Ruskoaho, H., Leskinen, H. (2007). Distinct Downregulation of C-Type Natriuretic Peptide System in Human Aortic Valve Stenosis. Circulation 116: 1283-1289 [Abstract] [Full Text]  
• Nemcsik, J., Farkas, K., Kolossvary, E., Jarai, Z., Egresits, J., Borgulya, G., Kiss, I., Lengyel, M. (2007). Intracardiac Calcification Is a Marker of Generalized Atherosclerosis. ANGIOLOGY 58: 413-419 [Abstract]  
• Grotenhuis, H. B., Ottenkamp, J., Westenberg, J. J.M., Bax, J. J., Kroft, L. J.M., de Roos, A. (2007). Reduced aortic elasticity and dilatation are associated with aortic regurgitation and left ventricular hypertrophy in nonstenotic bicuspid aortic valve patients.. J Am Coll Cardiol 49: 1660-1665 [Abstract] [Full Text]  
• Messika-Zeitoun, D., Bielak, L. F., Peyser, P. A., Sheedy, P. F., Turner, S. T., Nkomo, V. T., Breen, J. F., Maalouf, J., Scott, C., Tajik, A. J., Enriquez-Sarano, M. (2007). Aortic Valve Calcification: Determinants and Progression in the Population. Arterioscler. Thromb. Vasc. Bio. 27: 642-648 [Abstract] [Full Text]  
• Bella, J. N., Tang, W., Kraja, A., Rao, D. C., Hunt, S. C., Miller, M. B., Palmieri, V., Roman, M. J., Kitzman, D. W., Oberman, A., Devereux, R. B., Arnett, D. K. (2007). Genome-Wide Linkage Mapping for Valve Calcification Susceptibility Loci in Hypertensive Sibships: The Hypertension Genetic Epidemiology Network Study. Hypertension 49: 453-460 [Abstract] [Full Text]  
• Griffin, B. P. (2007). Statins in Aortic Stenosis: New Data From a Prospective Clinical Trial. J Am Coll Cardiol 49: 562-564 [Full Text]  
• Moura, L. M., Ramos, S. F., Zamorano, J. L., Barros, I. M., Azevedo, L. F., Rocha-Goncalves, F., Rajamannan, N. M. (2007). Rosuvastatin Affecting Aortic Valve Endothelium to Slow the Progression of Aortic Stenosis. J Am Coll Cardiol 49: 554-561 [Abstract] [Full Text]  
• Authors/Task Force Members, , Vahanian, A., Baumgartner, H., Bax, J., Butchart, E., Dion, R., Filippatos, G., Flachskampf, F., Hall, R., Iung, B., Kasprzak, J., Nataf, P., Tornos, P., Torracca, L., Wenink, A., ESC Committee for Practice Guidelines (CPG), , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, J., Dean, V., Deckers, J., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J., Zamorano, J. L., Document Reviewers, , Zamorano, J. L., Angelini, A., Antunes, M., Fernandez, M. A. G., Gohlke-Baerwolf, C., Habib, G., McMurray, J., Otto, C., Pierard, L., Pomar, J. L., Prendergast, B., Rosenhek, R., Uva, M. S., Tamargo, J. (2007). Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J 0: ehl428v1-39 [Full Text]  
• Koos, R., Kuhl, H. P., Muhlenbruch, G., Wildberger, J. E., Gunther, R. W., Mahnken, A. H. (2006). Prevalence and Clinical Importance of Aortic Valve Calcification Detected Incidentally on CT Scans: Comparison with Echocardiography. Radiology 241: 76-82 [Abstract] [Full Text]  
• Valfre, C., Rizzoli, G., Zussa, C., Ius, P., Polesel, E., Mirone, S., Bottio, T., Gerosa, G. (2006). Clinical results of Hancock II versus Hancock Standard at long-term follow-up.. J. Thorac. Cardiovasc. Surg. 132: 595-601.e2 [Abstract] [Full Text]  
• Bonow, R. O., Carabello, B. A., Chatterjee, K., de Leon, A. C. Jr, Faxon, D. P., Freed, M. D., Gaasch, W. H., Lytle, B. W., Nishimura, R. A., O'Gara, P. T., O'Rourke, R. A., Otto, C. M., Shah, P. M., Shanewise, J. S., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Lytle, B. W., Nishimura, R., Page, R. L., Riegel, B. (2006). ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol 48: e1-e148 [Full Text]  
• Bonow, R. O., Carabello, B. A., Chatterjee, K., de Leon, A. C. Jr, Faxon, D. P., Freed, M. D., Gaasch, W. H., Lytle, B. W., Nishimura, R. A., O'Gara, P. T., O'Rourke, R. A., Otto, C. M., Shah, P. M., Shanewise, J. S., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Lytle, B. W., Nishimura, R., Page, R. L., Riegel, B. (2006). ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol 48: 598-675 [Full Text]  
• O'Brien, K. D. (2006). Pathogenesis of Calcific Aortic Valve Disease: A Disease Process Comes of Age (and a Good Deal More). Arterioscler. Thromb. Vasc. Bio. 26: 1721-1728 [Abstract] [Full Text]  
• Shao, J.-S., Cai, J., Towler, D. A. (2006). Molecular Mechanisms of Vascular Calcification: Lessons Learned From The Aorta. Arterioscler. Thromb. Vasc. Bio. 26: 1423-1430 [Abstract] [Full Text]  
• Alkadhi, H., Wildermuth, S., Plass, A., Bettex, D., Baumert, B., Leschka, S., Desbiolles, L. M., Marincek, B., Boehm, T. (2006). Aortic Stenosis: Comparative Evaluation of 16-Detector Row CT and Echocardiography. Radiology 240: 47-55 [Abstract] [Full Text]  
• Floyd, T. F., Shah, P. N., Price, C. C., Harris, F., Ratcliffe, S. J., Acker, M. A., Bavaria, J. E., Rahmouni, H., Kuersten, B., Wiegers, S., McGarvey, M. L., Woo, J. Y., Pochettino, A. A., Melhem, E. R. (2006). Clinically Silent Cerebral Ischemic Events After Cardiac Surgery: Their Incidence, Regional Vascular Occurrence, and Procedural Dependence. Ann. Thorac. Surg. 81: 2160-2166 [Abstract] [Full Text]  
• Newby, D E, Cowell, S J, Boon, N A (2006). Emerging medical treatments for aortic stenosis: statins, angiotensin converting enzyme inhibitors, or both?. Heart 92: 729-734 [Abstract] [Full Text]  
• Katz, R., Wong, N. D., Kronmal, R., Takasu, J., Shavelle, D. M., Probstfield, J. L., Bertoni, A. G., Budoff, M. J., O'Brien, K. D. (2006). Features of the Metabolic Syndrome and Diabetes Mellitus as Predictors of Aortic Valve Calcification in the Multi-Ethnic Study of Atherosclerosis. Circulation 113: 2113-2119 [Abstract] [Full Text]  
• Lichtenstein, S. V. (2006). Closed heart surgery: Back to the future. J. Thorac. Cardiovasc. Surg. 131: 941-943 [Full Text]  
• Fox, C. S., Larson, M. G., Vasan, R. S., Guo, C.-Y., Parise, H., Levy, D., Leip, E. P., O'Donnell, C. J., D'Agostino, R. B. Sr., Benjamin, E. J. (2006). Cross-Sectional Association of Kidney Function with Valvular and Annular Calcification: The Framingham Heart Study. J. Am. Soc. Nephrol. 17: 521-527 [Abstract] [Full Text]  
• Butcher, J. T., Tressel, S., Johnson, T., Turner, D., Sorescu, G., Jo, H., Nerem, R. M. (2006). Transcriptional Profiles of Valvular and Vascular Endothelial Cells Reveal Phenotypic Differences: Influence of Shear Stress. Arterioscler. Thromb. Vasc. Bio. 26: 69-77 [Abstract] [Full Text]  
• Kizer, J. R., Wiebers, D. O., Whisnant, J. P., Galloway, J. M., Welty, T. K., Lee, E. T., Best, L. G., Resnick, H. E., Roman, M. J., Devereux, R. B. (2005). Mitral Annular Calcification, Aortic Valve Sclerosis, and Incident Stroke in Adults Free of Clinical Cardiovascular Disease: The Strong Heart Study. Stroke 36: 2533-2537 [Abstract] [Full Text]  
• Aranki, S. F., Nathan, M., Shekar, P., Couper, G., Rizzo, R., Cohn, L. H. (2005). Hypothermic Circulatory Arrest Enables Aortic Valve Replacement in Patients With Unclampable Aorta. Ann. Thorac. Surg. 80: 1679-1687 [Abstract] [Full Text]  
• Nightingale, A K, Horowitz, J D (2005). Aortic sclerosis: not an innocent murmur but a marker of increased cardiovascular risk. Heart 91: 1389-1393 [Abstract] [Full Text]  
• Christ, M., Sharkova, Y., Geldner, G., Maisch, B. (2005). Preoperative and Perioperative Care for Patients With Suspected or Established Aortic Stenosis Facing Noncardiac Surgery. Chest 128: 2944-2953 [Abstract] [Full Text]  
• Jimenez-Candil, J, Bermejo, J, Yotti, R, Cortina, C, Moreno, M, Cantalapiedra, J L, Garcia-Fernandez, M A (2005). Effects of angiotensin converting enzyme inhibitors in hypertensive patients with aortic valve stenosis: a drug withdrawal study. Heart 91: 1311-1318 [Abstract] [Full Text]  
• Lancellotti, P., Lebois, F., Simon, M., Tombeux, C., Chauvel, C., Pierard, L. A. (2005). Prognostic Importance of Quantitative Exercise Doppler Echocardiography in Asymptomatic Valvular Aortic Stenosis. Circulation 112: I-377-I-382 [Abstract] [Full Text]  
• Weisenberg, D., Sahar, Y., Sahar, G., Shapira, Y., Iakobishvili, Z., Vidne, B. A., Sagie, A. (2005). Atherosclerosis of the aorta is common in patients with severe aortic stenosis: An intraoperative transesophageal echocardiographic study. J. Thorac. Cardiovasc. Surg. 130: 29-32 [Abstract] [Full Text]  
• Melina, G., Horkaew, P., Amrani, M., Rubens, M. B., Yacoub, M. H., Yang, G.-Z. (2005). Three-dimensional in vivo characterization of calcification in native valves and in Freestyle versus homograft aortic valves. J. Thorac. Cardiovasc. Surg. 130: 41-47 [Abstract] [Full Text]  
• Freeman, R. V., Otto, C. M. (2005). Spectrum of Calcific Aortic Valve Disease: Pathogenesis, Disease Progression, and Treatment Strategies. Circulation 111: 3316-3326 [Full Text]  
• Pellikka, P. A., Sarano, M. E., Nishimura, R. A., Malouf, J. F., Bailey, K. R., Scott, C. G., Barnes, M. E., Tajik, A. J. (2005). Outcome of 622 Adults With Asymptomatic, Hemodynamically Significant Aortic Stenosis During Prolonged Follow-Up. Circulation 111: 3290-3295 [Abstract] [Full Text]  
• Cowell, S. J., Newby, D. E., Prescott, R. J., Bloomfield, P., Reid, J., Northridge, D. B., Boon, N. A., the Scottish Aortic Stenosis and Lipid Lowering Tr, (2005). A Randomized Trial of Intensive Lipid-Lowering Therapy in Calcific Aortic Stenosis. NEJM 352: 2389-2397 [Abstract] [Full Text]  
• Rosenhek, R. (2005). Statins for Aortic Stenosis. NEJM 352: 2441-2443 [Full Text]  
• Nash, P. J., Vitvitsky, E., Li, J., Cosgrove, D. M. III, Pettersson, G., Grimm, R. A. (2005). Feasibility of Valve Repair for Regurgitant Bicuspid Aortic Valves--An Echocardiographic Study. Ann. Thorac. Surg. 79: 1473-1479 [Abstract] [Full Text]  
• Kuusisto, J, Rasanen, K, Sarkioja, T, Alarakkola, E, Kosma, V-M (2005). Atherosclerosis-like lesions of the aortic valve are common in adults of all ages: a necropsy study. Heart 91: 576-582 [Abstract] [Full Text]  
• O'Brien, K. D., Probstfield, J. L., Caulfield, M. T., Nasir, K., Takasu, J., Shavelle, D. M., Wu, A. H., Zhao, X.-Q., Budoff, M. J. (2005). Angiotensin-Converting Enzyme Inhibitors and Change in Aortic Valve Calcium. Arch Intern Med 165: 858-862 [Abstract] [Full Text]  
• Simmons, C. A., Grant, G. R., Manduchi, E., Davies, P. F. (2005). Spatial Heterogeneity of Endothelial Phenotypes Correlates With Side-Specific Vulnerability to Calcification in Normal Porcine Aortic Valves. Circ. Res. 96: 792-799 [Abstract] [Full Text]  
• Chambers, J. (2005). Aortic stenosis. BMJ 330: 801-802 [Full Text]  
• Wang, A. Y.-M., Ho, S. S.-Y., Wang, M., Liu, E. K.-H., Ho, S., Li, P. K.-T., Lui, S.-F., Sanderson, J. E. (2005). Cardiac Valvular Calcification as a Marker of Atherosclerosis and Arterial Calcification in End-stage Renal Disease. Arch Intern Med 165: 327-332 [Abstract] [Full Text]  
• Le Gal, G, Bertault, V, Bezon, E, Cornily, J-C, Barra, J-A, Blanc, J-J (2005). Heterogeneous geographic distribution of patients with aortic valve stenosis: arguments for new aetiological hypothesis. Heart 91: 247-249 [Full Text]  
• (2005). Systolic murmur in an asymptomatic 70 year old man. Heart 91: 125-125 [Full Text]  
• Horne, B. D., Camp, N. J., Muhlestein, J. B., Cannon-Albright, L. A. (2004). Evidence for a Heritable Component in Death Resulting From Aortic and Mitral Valve Diseases. Circulation 110: 3143-3148 [Abstract] [Full Text]  
• Atak, R., Ileri, M., Yetkin, O., Yetkin, E., Turhan, H., Senen, K., Sahin, O., Ozbakir, C., Demikan, D. (2004). The Role of Valvular and Thoracic Aortic Calcifications in Distinction Between Ischemic and Nonischemic Cardiomyopathy. ANGIOLOGY 55: 661-667 [Abstract]  
• Atak, R., Ileri, M., Yetkin, O., Yetkin, E., Turhan, H., Senen, K., Sahin, O., Ozbakir, C., Demikan, D. (2004). The Role of Valvular and Thoracic Aortic Calcifications in Distinction Between Ischemic and Nonischemic Cardiomyopathy. ANGIOLOGY 55: 661-667 [Abstract]  
• Smith, W. T. IV, Ferguson, T. B. Jr, Ryan, T., Landolfo, C. K., Peterson, E. D. (2004). Should coronary artery bypass graft surgery patients with mild or moderate aortic stenosis undergo concomitant aortic valve replacement?: A decision analysis approach to the surgical dilemma. J Am Coll Cardiol 44: 1241-1247 [Abstract] [Full Text]  
• Rosenhek, R., Rader, F., Loho, N., Gabriel, H., Heger, M., Klaar, U., Schemper, M., Binder, T., Maurer, G., Baumgartner, H. (2004). Statins but Not Angiotensin-Converting Enzyme Inhibitors Delay Progression of Aortic Stenosis. Circulation 110: 1291-1295 [Abstract] [Full Text]  
• Salem, D. N., Stein, P. D., Al-Ahmad, A., Bussey, H. I., Horstkotte, D., Miller, N., Pauker, S. G. (2004). Antithrombotic Therapy in Valvular Heart Disease--Native and Prosthetic: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126: 457S-482S [Abstract] [Full Text]  
• Carabello, B. A. (2004). Is it ever too late to operate on the patient with valvular heart disease?. J Am Coll Cardiol 44: 376-383 [Abstract] [Full Text]  
• Messika-Zeitoun, D., Aubry, M.-C., Detaint, D., Bielak, L. F., Peyser, P. A., Sheedy, P. F., Turner, S. T., Breen, J. F., Scott, C., Tajik, A. J., Enriquez-Sarano, M. (2004). Evaluation and Clinical Implications of Aortic Valve Calcification Measured by Electron-Beam Computed Tomography. Circulation 110: 356-362 [Abstract] [Full Text]  
• Batur, P., Stewart, W. J., Isaacson, J. H. (2004). Aortic Stenosis and Unexplained Gastrointestinal Bleeding--Reply. Arch Intern Med 164: 679-680 [Full Text]  
• Ortlepp, J. R, Schmitz, F., Mevissen, V., Weiss, S., Huster, J., Dronskowski, R., Langebartels, G., Autschbach, R., Zerres, K., Weber, C., Hanrath, P., Hoffmann, R. (2004). The amount of calcium-deficient hexagonal hydroxyapatite in aortic valves is influenced by gender and associated with genetic polymorphisms in patients with severe calcific aortic stenosis. Eur Heart J 25: 514-522 [Abstract] [Full Text]  
• Yacoub, M. H., Cohn, L. H. (2004). Novel Approaches to Cardiac Valve Repair: From Structure to Function: Part I. Circulation 109: 942-950 [Full Text]  
• Otto, C. M. (2004). Aortic stenosis: even mild disease is significant. Eur Heart J 25: 185-187 [Full Text]  
• Rosenhek, R., Klaar, U., Schemper, M., Scholten, C., Heger, M., Gabriel, H., Binder, T., Maurer, G., Baumgartner, H. (2004). Mild and moderate aortic stenosis: Natural history and risk stratification by echocardiography. Eur Heart J 25: 199-205 [Abstract] [Full Text]  
• Chandra, H. R., Goldstein, J. A., Choudhary, N., O'Neill, C. S., George, P. B., Gangasani, S. R., Cronin, L., Marcovitz, P. A., Hauser, A. M., O'Neill, W. W. (2004). Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation. J Am Coll Cardiol 43: 169-175 [Abstract] [Full Text]  
• Soylu, M., Demir, A. D., Ozdemir, O., Uzun, Y., Korkmaz, S. (2003). Relationship Between Plaque Morphology of Carotid Artery and Aortic Valve Calcification. ANGIOLOGY 54: 637-640 [Abstract]  
• Novaro, G. M., Sachar, R., Pearce, G. L., Sprecher, D. L., Griffin, B. P. (2003). Association Between Apolipoprotein E Alleles and Calcific Valvular Heart Disease. Circulation 108: 1804-1808 [Abstract] [Full Text]  
• Morgan-Hughes, G J, Owens, P E, Roobottom, C A, Marshall, A J (2003). Three dimensional volume quantification of aortic valve calcification using multislice computed tomography. Heart 89: 1191-1194 [Abstract] [Full Text]  
• Pate, G. E., Tahir, M. N., Murphy, R. T., Foley, J. B. (2003). Anti-inflammatory Effects of Statins in Patients with Aortic Stenosis. J CARDIOVASC PHARMACOL THER 8: 201-206 [Abstract]  
• Ortlepp, J R, Schmitz, F, Bozoglu, T, Hanrath, P, Hoffmann, R (2003). Cardiovascular risk factors in patients with aortic stenosis predict prevalence of coronary artery disease but not of aortic stenosis: an angiographic pair matched case-control study. Heart 89: 1019-1022 [Abstract] [Full Text]  
• Rajamannan, N. M., Edwards, W. D., Spelsberg, T. C. (2003). Hypercholesterolemic Aortic-Valve Disease. NEJM 349: 717-718 [Full Text]  
• Alpert, J. S. (2003). Aortic Stenosis: A New Face for an Old Disease. Arch Intern Med 163: 1769-1770 [Full Text]  
• Batur, P., Stewart, W. J., Isaacson, J. H. (2003). Increased Prevalence of Aortic Stenosis in Patients With Arteriovenous Malformations of the Gastrointestinal Tract in Heyde Syndrome. Arch Intern Med 163: 1821-1824 [Abstract] [Full Text]  
• Bashore, T. M., Gardner, T. J. (2003). Valvular heart disease. J Am Coll Cardiol 42: 388-390 [Full Text]  
• Rajamannan, N. M, Gersh, B., Bonow, R. O (2003). CALCIFIC AORTIC STENOSIS: FROM BENCH TO THE BEDSIDE--EMERGING CLINICAL AND CELLULAR CONCEPTS. Heart 89: 801-805 [Full Text]  
• Fox, C. S., Vasan, R. S., Parise, H., Levy, D., O'Donnell, C. J., D'Agostino, R. B., Benjamin, E. J. (2003). Mitral Annular Calcification Predicts Cardiovascular Morbidity and Mortality: The Framingham Heart Study. Circulation 107: 1492-1496 [Abstract] [Full Text]  
• Nkomo, V. T., Enriquez-Sarano, M., Ammash, N. M., Melton, L. J. III, Bailey, K. R., Desjardins, V., Horn, R. A., Tajik, A. J. (2003). Bicuspid Aortic Valve Associated With Aortic Dilatation: A Community-Based Study. Arterioscler. Thromb. Vasc. Bio. 23: 351-356 [Abstract] [Full Text]  
• Poggianti, E., Venneri, L., Chubuchny, V., Jambrik, Z., Baroncini, L. A., Picano, E. (2003). Aortic valve sclerosis is associatedwith systemic endothelial dysfunction. J Am Coll Cardiol 41: 136-141 [Abstract] [Full Text]  
• Bermejo, J., Odreman, R., Feijoo, J., Moreno, M. M., Gomez-Moreno, P., Garcia-Fernandez, M. A. (2003). Clinical efficacy of Doppler-echocardiographic indices of aortic valve stenosis:a comparative test-based analysis of outcome. J Am Coll Cardiol 41: 142-151 [Abstract] [Full Text]  
• Wang, A. Y.-M., Wang, M., Woo, J., Lam, C. W.-K., Li, P. K.-T., Lui, S.-F., Sanderson, J. E. (2003). Cardiac Valve Calcification as an Important Predictor for All-Cause Mortality and Cardiovascular Mortality in Long-Term Peritoneal Dialysis Patients: A Prospective Study. J. Am. Soc. Nephrol. 14: 159-168 [Abstract] [Full Text]  
• Schoen, F. J., Padera, R. F. Jr. (2003). Cardiac Surgical Pathology. Card Surg Adult 2: 119-185 [Full Text]  
• Cosmi, J. E., Kort, S., Tunick, P. A., Rosenzweig, B. P., Freedberg, R. S., Katz, E. S., Applebaum, R. M., Kronzon, I. (2002). The Risk of the Development of Aortic Stenosis in Patients With "Benign" Aortic Valve Thickening. Arch Intern Med 162: 2345-2347 [Abstract] [Full Text]  
• Jensen-Urstad, K, Svenungsson, E, de Faire, U, Silveira, A, Witztum, J L, Hamsten, A, Frostegard, J (2002). Cardiac valvular abnormalities are frequent in systemic lupus erythematosus patients with manifest arterial disease. Lupus 11: 744-752 [Abstract]  
• Wallby, L, Janerot-Sjoberg, B, Steffensen, T, Broqvist, M (2002). T lymphocyte infiltration in non-rheumatic aortic stenosis: a comparative descriptive study between tricuspid and bicuspid aortic valves. Heart 88: 348-351 [Abstract] [Full Text]  
• Willmann, J. K., Weishaupt, D., Lachat, M., Kobza, R., Roos, J. E., Seifert, B., Luscher, T. F., Marincek, B., Hilfiker, P. R. (2002). Electrocardiographically Gated Multi-Detector Row CT for Assessment of Valvular Morphology and Calcification in Aortic Stenosis. Radiology 225: 120-128 [Abstract] [Full Text]  
• Belhassen, L., Carville, C., Pelle, G., Monin, J. L., Teiger, E., Duval-Moulin, A.-M., Dupouy, P., Dubois Rande, J. L., Gueret, P. (2002). Evaluation of carotid artery and aortic intima-media thickness measurements for exclusion of significant coronary atherosclerosis in patients scheduled for heart valve surgery. J Am Coll Cardiol 39: 1139-1144 [Abstract] [Full Text]