Aortic Stenosis in Subjects With Heterozygous Familial Hypercholesterolemia on Prolonged Treatment With Statins

Study Overview
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Brief Summary
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Aortic stenosis (AE) is a disease that has been increasing steadily in recent years in most countries, including Spain.Risk factors for the development of AE include age, hypercholesterolemia, diabetes mellitus and arterial hypertension, the classic risk factors for the development of atherosclerosis. However, lipid-lowering therapy with statins and ezetimibe has not been shown to reduce the risk of long-term progression of AE by unknown mechanisms. All this suggests that subjects with HFhe have a high risk of developing AD, which has not been shown by the high coronary mortality in this population that precedes aortic calcification

Detailed Description
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The study includes a single clinical visit with collection of clinical data, blood extraction and the performance of a transthoracic echocardiogram. This visit may be made on different days, but always within 30 days of signing the informed consent.

Official Title
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Aortic Stenosis in Subjects With Heterozygous Familial Hypercholesterolemia on Prolonged Treatment With Statins

Conditions
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Aortic Stenosis, Arteriosclerosis, Familial Hypercholesterolemia, Conventional Transthoracic Echocardiogram

Intervention / Treatment
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* Procedure: Echocardiogram


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cases: Age ≥ 65 years at the time of cardiac ultrasound Genetically diagnosed HFH or in a first-degree relative History of hypercholesterolemia with LDLc levels> 220 mg / dL without lipid-lowering treatment Controls: Genetically Similar Siblings of the normoccholesterolemic case, defined by LDLc <190 mg / dl without lipid-lowering treatment. In the absence of available siblings, first cousins may be included. In the presence of several siblings available, the same sex will be included, Environmentally similar Stable partner of the case with cohabitation> 25 years * Each case will have at least one control. Exclusion Criteria: - Personal history of cardiac rheumatic disease

Ages Eligible for Study
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Minimum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| CASES<br>Cases: Age ≥ 65 years at the time of cardiac ultrasound Genetically diagnosed HFH or in a first-degree relative History of hypercholesterolemia with LDLc levels> 220 mg / dL without lipid-lowering treatment | Procedure: Echocardiogram<br>* Conventional transthoracic echocardiogram by an echocardiographer trained to perform and centered on aortic valve Pick up from: Mean transvalvular pressure gradient Aortic valve Aortic valve opening area Aortic valve opening area adjusted for body mass index Bicuspid or tricuspid aorta Thickness of the upper valve> 3 mm<br>|
| Controls<br>Genetically Similar Siblings of the normocholesterolemic case, defined by LDLc <190 mg / dl without lipid-lowering treatment. In the absence of available siblings, first cousins may be included. In the presence of several siblings available, the same sex will be included, Environmentally similar Stable partner of the case with cohabitation> 25 years | Procedure: Echocardiogram<br>* Conventional transthoracic echocardiogram by an echocardiographer trained to perform and centered on aortic valve Pick up from: Mean transvalvular pressure gradient Aortic valve Aortic valve opening area Aortic valve opening area adjusted for body mass index Bicuspid or tricuspid aorta Thickness of the upper valve> 3 mm<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Differences in age-adjusted prevalence of EA assessed by transthoracic echocardiography between cases and controls |  | 1 YEAR | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Differences in age-adjusted prevalence of AD assessed by transthoracic echocardiography between cases and controls |  | 1 YEAR | 
| Difference in aortic surface between cases and controls |  | 1 YEAR | 
| Difference in the mean transvalvular gradient between cases and controls |  | 1 YEAR | 
| Difference between maximum aortic jet velocity between cases and controls |  | 1 YEAR |