Purpose. Echocardiography (ECHO) is the most commonly performed cardiac imaging investigation. Common carotid artery (CCA) intimal medial thickness (IMT) is a useful screening test for the detection of atherosclerosis. Recent evidence has suggested an association between degenerative aortic valve disease and the presence of atherosclerosis. The purpose of our investigation was to determine the sensitivity, specificity and predictive values of the ECHO finding of mild aortic valve sclerosis for the detection of carotid atherosclerosis.
Methods. Over the past 4 years 993 patients (P) have had both carotid duplex imaging and ECHO performed within 1 year of each other. P with mild aortic valve sclerosis were included. A CCA IMT of >1.0mm was considered abnormal, as was any degree of internal carotid artery stenosis (ICA) using ICAVL imaging and velocity criteria. A CCA IMT of <1.00mm and no ICA stenosis was considered normal. Statistics were based on the carotid being the gold standard for the presence or absence of atherosclerosis. Calculations were made for sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. The calculations were performed for men ≥40 years (M) and women ≥50 years (W).
Results. See Table 1.
Conclusions. The presence of mild aortic valve sclerosis has a high PPV of 93.3% in M and 84.4% in W for the presence of carotid atherosclerosis. The NPV of 24.1% in M and 30.4% in W for a morphologically normal aortic valve is not clinically useful. The presence of mild aortic valve sclerosis on an ECHO report in M or F should lead one to check for other vascular risk factors. These finding suggest that such patients could benefit from vascular preventative therapies such as Aspirin and Statins.