Tiny Valve May Predict Heart Disease

	July 15, 1999 - The hardening or thickening of a tiny
heart valve - a common condition among the elderly that doctors
usually dismiss as unimportant - may be a powerful predictor of
heart attacks and strokes.
	Previous studies have shown that a severe narrowing or
blockage in the left aortic valve is a predictor of heart
disease. A new study, published in Thursday's New England
Journal of Medicine, has shown that a prior condition called
sclerosis can also be a warning sign.
	Sclerosis is a hardening or thickening in the aortic
valve, often due to a buildup of calcium deposits. This
condition is found in roughly 25% of all adults over 65. The
study offers hope that a simple screening procedure can predict
the risk of heart disease in people with no other symptoms.
The procedure, called echocardiography, uses ultrasound to
show a 2-dimensional picture of the heart. An "echo" costs
roughly $350 to $600.
	"Sclerosis itself has been thought to be just a normal
finding of aging because it's so common," said Dr. Catherine Otto
of the University of Washington in Seattle, who led the study.
"Having it is, however, not benign." Otto does not recommend
routine echocardiograms for everyone. Echocardiograms are usually
done after a doctor detects a heart murmur using a stethoscope.
Otto said that in light of her findings, that echo image should
be closely examined for sclerosis of the aortic valve.
	The researchers studied the echocardiograms of 5,621 men
and women aged 65 and older. The valve was normal in 70%. In 29%,
the valve was hardening or thickening, but there was no
obstruction. The valve was narrowing, meaning there was some
obstruction, in 2%. Following up 5 years later, the doctors found
that hardening of the valve is associated with a 50% higher risk
of death from heart disease compared with people who have normal
valves.
	The researchers do not believe that sclerosis is a direct
cause of death but rather a "marker" for heart disease.