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Chlamydia and Aortic Stenosis?

Infection with Chlamydia pneumoniae may be related to the development or progression of coronary atherosclerosis. This bacterium has also been found in severely stenotic aortic valves, but it may merely be a bystander occupying diseased tissue.

To explore the association between chlamydia infection and aortic stenosis, these Finnish investigators carefully examined the aortic valves of 46 consecutive cadavers undergoing autopsy. The presence of bacteria was assessed by immunohistochemistry. Early aortic valve disease was noted in 12 valves; none had severe aortic stenosis. chlamydia infection was present in 83 percent of the diseased valves, compared with only 44 percent of the normal valves. The association was particularly strong among patients over age 60: Early aortic valve disease was present in 87 percent of those with chlamydia infection, compared with only 14 percent of those without infection (P=0.01).

Comment: These data argue that chlamydia infection may well be associated with early aortic valve disease, although its relation to the development of hemodynamically significant aortic stenosis remains uncertain. Nonetheless, the report adds to the growing body of evidence of bacteria involvement in the pathogenesis of chronic heart disease. The therapeutic and preventive implications of chlamydia heart infection remain to be determined.

— MS Lauer

Published in Journal Watch Cardiology June 12, 1998

Citation(s):

Juvonen J et al. Can degenerative aortic valve stenosis be related to persistent Chlamydia pneumoniae infection?. Ann Intern Med 1998 May 1 128 741-744.

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