Aortic stenosis risk factors: Difference between revisions

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Latest revision as of 19:49, 3 March 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Mohammed A. Sbeih, M.D. [2]; Usama Talib, BSc, MD [3] Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]

Overview

The most common risk factor for the development of aortic stenosis is the presence of a congenital bicuspid aortic valve. Risk factors that may speed up the progression of aortic stenosis include the same risk factors as atherosclerosis.

Risk Factors

Common Risk Factors

Common risk factors in the development of aortic stenosis include:^[1]^[2]^[3]^[4]

Congenital bicuspid aortic valve that may subsequently become calcified later in life
Acute rheumatic fever
Age-related progressive calcification of the normal tricuspid aortic valve

Less common Risk Factors

Less common risk factors in the development of aortic stenosis include:^[5]^[6]^[7]^[8]

Other Risk Factors

Some other risk factors of aortic stenosis include:^[9]^[10]^[11]

Radiation therapy for cancer, such as breast cancer or lymphoma
High lipoprotein a
Disorders of calcium metabolism

References

↑ Siu SC, Silversides CK (2010). "Bicuspid aortic valve disease". J Am Coll Cardiol. 55 (25): 2789–800. doi:10.1016/j.jacc.2009.12.068. PMID 20579534.
↑ Mylonakis E, Calderwood SB (2001). "Infective endocarditis in adults". N Engl J Med. 345 (18): 1318–30. doi:10.1056/NEJMra010082. PMID 11794152.
↑ Lugiano, CA. (2013). "Aortic stenosis". JAAPA. 26 (11): 46–7. doi:10.1097/01.JAA.0000436518.69169.8e. PMID 24153092. Unknown parameter |month= ignored (help)
↑ Pawade TA, Newby DE, Dweck MR (2015). "Calcification in Aortic Stenosis: The Skeleton Key". J Am Coll Cardiol. 66 (5): 561–77. doi:10.1016/j.jacc.2015.05.066. PMID 26227196.
↑ Aronow WS, Schwartz KS, Koenigsberg M (1987). "Correlation of serum lipids, calcium, and phosphorus, diabetes mellitus and history of systemic hypertension with presence or absence of calcified or thickened aortic cusps or root in elderly patients". Am J Cardiol. 59 (9): 998–9. PMID 3565291.
↑ Lindroos M, Kupari M, Valvanne J, Strandberg T, Heikkilä J, Tilvis R (1994). "Factors associated with calcific aortic valve degeneration in the elderly". Eur Heart J. 15 (7): 865–70. PMID 7925504.
↑ Olsson M, Thyberg J, Nilsson J (1999). "Presence of oxidized low density lipoprotein in nonrheumatic stenotic aortic valves". Arterioscler Thromb Vasc Biol. 19 (5): 1218–22. PMID 10323772.
↑ Maher ER, Pazianas M, Curtis JR (1987). "Calcific aortic stenosis: a complication of chronic uraemia". Nephron. 47 (2): 119–22. PMID 3696315.
↑ Hull MC, Morris CG, Pepine CJ, Mendenhall NP (2003). "Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of hodgkin lymphoma treated with radiation therapy". JAMA. 290 (21): 2831–7. doi:10.1001/jama.290.21.2831. PMID 14657067.
↑ Gotoh T, Kuroda T, Yamasawa M, Nishinaga M, Mitsuhashi T, Seino Y; et al. (1995). "Correlation between lipoprotein(a) and aortic valve sclerosis assessed by echocardiography (the JMS Cardiac Echo and Cohort Study)". Am J Cardiol. 76 (12): 928–32. PMID 7484833.
↑ Linefsky JP, O'Brien KD, Katz R, de Boer IH, Barasch E, Jenny NS; et al. (2011). "Association of serum phosphate levels with aortic valve sclerosis and annular calcification: the cardiovascular health study". J Am Coll Cardiol. 58 (3): 291–7. doi:10.1016/j.jacc.2010.11.073. PMC 3147295. PMID 21737022.

Template:WH Template:WS CME Category::Cardiology

[pmid20579534-1] Siu SC, Silversides CK (2010). "Bicuspid aortic valve disease". J Am Coll Cardiol. 55 (25): 2789–800. doi:10.1016/j.jacc.2009.12.068. PMID 20579534.

[pmid11794152-2] Mylonakis E, Calderwood SB (2001). "Infective endocarditis in adults". N Engl J Med. 345 (18): 1318–30. doi:10.1056/NEJMra010082. PMID 11794152.

[Lugiano-2013-3] Lugiano, CA. (2013). "Aortic stenosis". JAAPA. 26 (11): 46–7. doi:10.1097/01.JAA.0000436518.69169.8e. PMID 24153092. Unknown parameter |month= ignored (help)

[pmid26227196-4] Pawade TA, Newby DE, Dweck MR (2015). "Calcification in Aortic Stenosis: The Skeleton Key". J Am Coll Cardiol. 66 (5): 561–77. doi:10.1016/j.jacc.2015.05.066. PMID 26227196.

[pmid3565291-5] Aronow WS, Schwartz KS, Koenigsberg M (1987). "Correlation of serum lipids, calcium, and phosphorus, diabetes mellitus and history of systemic hypertension with presence or absence of calcified or thickened aortic cusps or root in elderly patients". Am J Cardiol. 59 (9): 998–9. PMID 3565291.

[pmid7925504-6] Lindroos M, Kupari M, Valvanne J, Strandberg T, Heikkilä J, Tilvis R (1994). "Factors associated with calcific aortic valve degeneration in the elderly". Eur Heart J. 15 (7): 865–70. PMID 7925504.

[pmid10323772-7] Olsson M, Thyberg J, Nilsson J (1999). "Presence of oxidized low density lipoprotein in nonrheumatic stenotic aortic valves". Arterioscler Thromb Vasc Biol. 19 (5): 1218–22. PMID 10323772.

[pmid3696315-8] Maher ER, Pazianas M, Curtis JR (1987). "Calcific aortic stenosis: a complication of chronic uraemia". Nephron. 47 (2): 119–22. PMID 3696315.

[pmid14657067-9] Hull MC, Morris CG, Pepine CJ, Mendenhall NP (2003). "Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of hodgkin lymphoma treated with radiation therapy". JAMA. 290 (21): 2831–7. doi:10.1001/jama.290.21.2831. PMID 14657067.

[pmid7484833-10] Gotoh T, Kuroda T, Yamasawa M, Nishinaga M, Mitsuhashi T, Seino Y; et al. (1995). "Correlation between lipoprotein(a) and aortic valve sclerosis assessed by echocardiography (the JMS Cardiac Echo and Cohort Study)". Am J Cardiol. 76 (12): 928–32. PMID 7484833.

[pmid21737022-11] Linefsky JP, O'Brien KD, Katz R, de Boer IH, Barasch E, Jenny NS; et al. (2011). "Association of serum phosphate levels with aortic valve sclerosis and annular calcification: the cardiovascular health study". J Am Coll Cardiol. 58 (3): 291–7. doi:10.1016/j.jacc.2010.11.073. PMC 3147295. PMID 21737022.

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@@ Line 1: / Line 1: @@
-{{Template:Aortic stenosis}}
+__NOTOC__
-{{CMG}}
+{| class="infobox" style="float:right;"
+|-
+| [[File:Siren.gif|30px|link=Aortic stenosis resident survival guide]]|| <br> || <br>
+| [[Aortic stenosis resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
+|}
+{{Aortic stenosis}}
+{{CMG}}; '''Associate Editors-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]; {{USAMA}} '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu]
-'''Associate Editors-In-Chief:''' Claudia P. Hochberg, M.D. [mailto:chochber@bidmc.harvard.edu]; [[User:Abdarabi|Abdul-Rahman Arabi, M.D.]] [mailto:abdarabi@yahoo.com]; [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]
+==Overview==
+The most common [[risk factor]] for the development of aortic stenosis is the presence of a congenital [[bicuspid aortic valve]]. Risk factors that may speed up the progression of aortic stenosis include the same [[risk factors]] as [[atherosclerosis]].
-==Precautions==
+==Risk Factors==
-People with aortic stenosis of any aetiology are at risk for the development of infection of their stenosed valve, i.e. [[infective endocarditis]]. To lessen the chance of developing that serious complication, people with AS are usually advised to take antibiotic prophylaxis around the time of certain dental/medical/surgical procedures. Such procedures may include dental extraction, deep scaling of the teeth, gum surgery, dental implants, treatment of [[esophageal varices]], dilation of [[esophageal stricture]]s, gastrointestinal ''surgery'' where the intestinal [[mucosa]] will be disrupted, [[prostate]] surgery, [[urethral stricture]] dilation, and [[cystoscopy]]. Note that routine upper and lower GI [[endoscopy]] (i.e. [[gastroscopy]] and [[colonoscopy]]), with or without [[biopsy]], are not usually considered indications for antibiotic prophylaxis.
-Notwithstanding the foregoing, the American Heart Association has recently changed its recommendations regarding antibiotic prophylaxis for endocarditis. Specifically, as of 2007, it is recommended that such prophylaxis be limited only to
+=== '''Common Risk Factors''' ===
-#those with prosthetic heart valves
+Common risk factors in the development of aortic stenosis include:<ref name="pmid20579534">{{cite journal| author=Siu SC, Silversides CK| title=Bicuspid aortic valve disease. | journal=J Am Coll Cardiol | year= 2010 | volume= 55 | issue= 25 | pages= 2789-800 | pmid=20579534 | doi=10.1016/j.jacc.2009.12.068 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20579534  }} </ref><ref name="pmid11794152">{{cite journal| author=Mylonakis E, Calderwood SB| title=Infective endocarditis in adults. | journal=N Engl J Med | year= 2001 | volume= 345 | issue= 18 | pages= 1318-30 | pmid=11794152 | doi=10.1056/NEJMra010082 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11794152  }} </ref><ref name="Lugiano-2013">{{Cite journal | last1 = Lugiano | first1 = CA. | title = Aortic stenosis. | journal = JAAPA | volume = 26 | issue = 11 | pages = 46-7 | month = Nov | year = 2013 | doi = 10.1097/01.JAA.0000436518.69169.8e | PMID = 24153092 }}</ref><ref name="pmid26227196">{{cite journal| author=Pawade TA, Newby DE, Dweck MR| title=Calcification in Aortic Stenosis: The Skeleton Key. | journal=J Am Coll Cardiol | year= 2015 | volume= 66 | issue= 5 | pages= 561-77 | pmid=26227196 | doi=10.1016/j.jacc.2015.05.066 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26227196  }} </ref>
-#those with previous episode(s) of endocarditis
+*Congenital [[bicuspid aortic valve]] that may subsequently become calcified later in life
-#those with certain types of congenital heart disease.<ref>http://www.americanheart.org/presenter.jhtml?identifier=4436</ref>
+*Acute [[rheumatic fever]]
+*[[Calcific aortic valve disease|Age-related progressive calcification]] of the normal tricuspid aortic valve
-Since the stenosed aortic valve may limit the heart's output, people with aortic stenosis are at risk of [[syncope]] and dangerously low blood pressure should they use any of a number of common medications. Ironically, these same medicines are used to treat a variety of cardiovascular diseases, many of which may co-exist with aortic stenosis. Examples include [[nitroglycerin]], [[nitrates]], [[ACE inhibitor]]s, [[terazosin]] (Hytrin), and [[hydralazine]]. Note that all of these substances lead to peripheral [[vasodilation]]. Normally, however, in the absence of aortic stenosis, the heart is able to increase its output and thereby offset the effect of the dilated blood vessels. In some cases of aortic stenosis, however, due to the obstruction of blood flow out of the heart caused by the stenosed aortic valve, [[cardiac output]] cannot be increased. Low blood pressure or [[syncope]] may ensue.
+==='''Less common Risk Factors'''===
+Less common risk factors in the development of aortic stenosis include:<ref name="pmid3565291">{{cite journal| author=Aronow WS, Schwartz KS, Koenigsberg M| title=Correlation of serum lipids, calcium, and phosphorus, diabetes mellitus and history of systemic hypertension with presence or absence of calcified or thickened aortic cusps or root in elderly patients. | journal=Am J Cardiol | year= 1987 | volume= 59 | issue= 9 | pages= 998-9 | pmid=3565291 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3565291  }} </ref><ref name="pmid7925504">{{cite journal| author=Lindroos M, Kupari M, Valvanne J, Strandberg T, Heikkilä J, Tilvis R| title=Factors associated with calcific aortic valve degeneration in the elderly. | journal=Eur Heart J | year= 1994 | volume= 15 | issue= 7 | pages= 865-70 | pmid=7925504 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7925504  }} </ref><ref name="pmid10323772">{{cite journal| author=Olsson M, Thyberg J, Nilsson J| title=Presence of oxidized low density lipoprotein in nonrheumatic stenotic aortic valves. | journal=Arterioscler Thromb Vasc Biol | year= 1999 | volume= 19 | issue= 5 | pages= 1218-22 | pmid=10323772 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10323772  }} </ref><ref name="pmid3696315">{{cite journal| author=Maher ER, Pazianas M, Curtis JR| title=Calcific aortic stenosis: a complication of chronic uraemia. | journal=Nephron | year= 1987 | volume= 47 | issue= 2 | pages= 119-22 | pmid=3696315 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3696315  }} </ref>
+*[[Diabetes mellitus]]
+*[[High cholesterol]]
+*[[Hypertension]]
+* [[Low HDL]]
+*[[Uremia]]
+==='''Other Risk Factors'''===
+Some other [[risk factors]] of aortic stenosis include:<ref name="pmid14657067">{{cite journal| author=Hull MC, Morris CG, Pepine CJ, Mendenhall NP| title=Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of hodgkin lymphoma treated with radiation therapy. | journal=JAMA | year= 2003 | volume= 290 | issue= 21 | pages= 2831-7 | pmid=14657067 | doi=10.1001/jama.290.21.2831 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14657067  }} </ref><ref name="pmid7484833">{{cite journal| author=Gotoh T, Kuroda T, Yamasawa M, Nishinaga M, Mitsuhashi T, Seino Y et al.| title=Correlation between lipoprotein(a) and aortic valve sclerosis assessed by echocardiography (the JMS Cardiac Echo and Cohort Study). | journal=Am J Cardiol | year= 1995 | volume= 76 | issue= 12 | pages= 928-32 | pmid=7484833 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7484833  }} </ref><ref name="pmid21737022">{{cite journal| author=Linefsky JP, O'Brien KD, Katz R, de Boer IH, Barasch E, Jenny NS et al.| title=Association of serum phosphate levels with aortic valve sclerosis and annular calcification: the cardiovascular health study. | journal=J Am Coll Cardiol | year= 2011 | volume= 58 | issue= 3 | pages= 291-7 | pmid=21737022 | doi=10.1016/j.jacc.2010.11.073 | pmc=PMC3147295 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21737022  }} </ref>
+*[[Radiation therapy]] for cancer, such as [[breast cancer]] or [[lymphoma]]
+* High [[lipoprotein a]]
+* Disorders of [[calcium]] metabolism
 ==References==
 {{reflist|2}}
+{{WH}}
+{{WS}}
+[[CME Category::Cardiology]]
-{{Circulatory system pathology}}
+[[Category:Disease]]
-{{Congenital malformations and deformations of circulatory system}}
-[[Category:DiseaseState]]
-[[Category:Signs and symptoms]]
-[[Category:Physical Examination]]
 [[Category:Valvular heart disease]]
 [[Category:Cardiology]]
 [[Category:Congenital heart disease]]
+[[Category:Cardiac surgery]]
-[[de:Aortenstenose (angeboren)]]
+[[Category:Surgery]]
-[[es:Estenosis aórtica]]
-[[fr:Rétrécissement aortique]]
-[[no:Aortastenose]]
-[[nn:Aortastenose]]
-[[pl:Stenoza Aortalnej]]
-[[pt:Estenose aórtica]]
-[[ro:Stenoza Aortică]]
-[[sv:Aortastenos]]
-[[tr:Aort darlığı]]
-{{WH}}
-{{WS}}