(HealthDay News) – More than one-fifth of healthy middle-aged men have a low-grade systolic heart murmur that confers a nearly five-fold higher risk of future aortic valve replacement (AVR).
Johan Bodegard, MD, PhD, of the Oslo University Hospital in Norway, and colleagues conducted a study involving 2,014 healthy Norwegian men, aged 40–59 years, who underwent heart auscultation to detect systolic heart murmur along with other standard clinical tests between 1972–1975. Of these, 1,541 (76.5%) had no heart murmur, 441 (21.9%) had a low-grade (grade I/II) murmur, and 32 (1.6%) had a moderate (grade III/IV) murmur. Patients were followed for up to 35 years to determine whether the presence of a low-grade systolic murmur was associated with an increased long-term risk of AVR or cardiovascular disease (CVD) mortality.
The researchers found that men with a low-grade systolic murmur had a 4.7-fold increased age-related risk of AVR, but no increased risk of mortality due to CVD. Men with a moderate-grade systolic murmur had an 89.3-fold increased risk of AVR and a 1.5-fold, but not statistically significant, increased risk of death due to CVD.
“Low-grade systolic murmur was found in more than one-fifth of apparently healthy middle-aged men with normal exercise capacity,” the authors write. “Men with low-grade systolic murmur have a late development of AVR requirement, and we suggest that an auscultatory follow-up at five years could safely replace an immediate referral for echocardiography.”