| Objective:Senile Degenerated Heart Valvular Diseases(SDHVD) is a result of degenerated prossese in fibra layer of cardiac valve as well as calcium deposition. The incidence of SDHVD kept rising in recent years and valvular degeneration in elder has become a major cause of valvular disease and valve replacement both in developed countries and in developed areas in China. This study is aimed at investigating prevalence and constituent ratio of SDHVD among military older people in Beijing, identifying possible risk factors and the relationship between SDHVD and carotid atherosclerolosis, providing some reliable epidemiological information for the clinical strategy in the prevention of SDHVD. Materials and methods:1. Study of prevalence and constituent ratio: The target populations were retired military officers and their spouses, aged 60 or above, including 8202 individuals from 21 military cadre retirement centers surveyed at random in Beijing. 820 individuals, including 426 males and 394 females, averaging 70.66 ±5.87 of age, were randomly selected out of the 8202 individuals for different age groups. Each individual answered a questionnaire and received Doppler echocardiographic examination for an observation of the cardiac structure, function and valve condition especially valvular calcification and valvular regurgitation. The results were used in the calculation of the prevalence and constituent ratio of SDHVD by different sexes and age groups in target population, as well as the pathological characters and hemodynamic effects of SDHVD in different populations.2. Study on relative risk factors of SDVHD: The same population were enrolled and divided into two groups: calcificated valve group andnone-calificated valve group, based on their echocardiograph. Distribution analyses were made with comparisons between the two groups concerning fourteen relative risk factors: age, sex, smoking, alcohol, sleep, obesity, character type, physical activity intensity, history of hypertention, coronary heart disease, Diabetes mellitus, stroke and hyperlipemia. A logistic regression analysis between the groups was also made to identify possible risk factors and their powers on the prevalence of SDVHD.3. Study on the relationship between SDVHD and carotid atherosclerosis: Sonography of common carotid arteries, internal carotid arteries and external carotid arteries on both sides were performed in the same subjects of previous studies, and the arteries' internal diameters, intima media thickness(IMT), peak flow velocity(PFV) of common carotid artery and the size of artery plaques were measured as an investigation into the relationship between SDVHD and carotid atherosclerosis. Results:1. The prevalence ratio of SDHVD by means of ultrasonic examinations among military older people in Beijing was 13.4 %, of which males taked 12.2 % while females taked 14.7 %. Among them, the prevalence ratio of SDHVD for ages of 60 - 69,70 - 79, and 80 or above were 7.7%, 16.1%, 25.7% respectively, totaling 110 cases of calcificated valve, included 45.4 % of aotic valve, 35.4 % of mitral valve, 17.3% of mitral valve with combined aotic valvular calcification, and 0.9 % of tricuspid valve. Most of location of valvular calcification were annular calcification, taking 52.7 %, with valvular body nexted to it, taking 24.5%, and cusp calcification the lowest, taking about 8%。 Most of valvular calcification in male were aotic valve calcification, taking 57.7%, with mitral valve calcification next to it, taking 26.9%, and aotic valve with combined mitral valvular calcification taking 15.4%. Most of valvular calcification in female were mitral valve calcification, taking 43.1%, with aotic valve calcifition next to it, taking 34.5%. Most of mitral valve calcification were posterior leaflet, taking68.0%. Non coronary cusps were frequently involved in aotic valvular calcification, taking 51.0%. Of valvular Regurgitation, aotic valve reguigitation in calcificated group taked 21.8% , while aotic valve regurgitation in non-calcificated group taked 10.4%.2. Of the SDVHD patients by ultrasonic examinations, the 14 risk factors between the two groups provided different statistics descriptions with obviously different distributions concerning the age, physical activity intensity, obesity, hyperlipemiastroke and coronary heart disease. With weather valvular calcificated as dependent and SCHVD risk factors as covariates, the logistic regression was done to provide the following results: SDHVD risk factors included the age, hypertention, hyperlipemia, stroke and cadiovascular family history, of which the age increasing was the most risky factor.3. The prevalence of carotid atherosclerosis by ultrasonic examinations among the military elderly population in Beijing was 44.0%, of which males taked 53.8% and females taked 33.5%. The prevalence rised with the increase of age. In IMT ordinary group, the prevalence of valvular calcification was 10.0%, while in carotid atherosclerosis group, the prevalence of valvular calcification was 17.7 %. The different prevalence of valvular calcification between the two groups were of statistical importance.Conclusion:1. The prevalence of SDVHD among the military elderly population in Beijing rised with the increasing of age. Valve annulus was the most frequently found, of which most aotic valve calcification happened to males and mitral valve calcification to females, with no statistical difference of prevalence between different sexes, posterior leaflet were more frequently involved in mitral valve calcification than anterior leaflet while non coronary cusps were frequently involved in aotic valvular calcification among three cusps. Valvular Regurgitation especially aotic valve reguigitation were common than valvular stenosis among people with valvular calcification. The SDVHD examinations by Doppler... |
PDF Full Text Request