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Background: Sclerosis of the sinus of valsalva correlates with cardiovascular disease burden. The anatomic proximity of the aortic root to the conduction system suggests potential association between sinus of valsalva sclerosis and conduction abnormalities. Methods: ECGs and clinical records from 129 consecutive patients undergoing transesophageal echocardiography for routine stroke work-up were collected from a single centre database. TEE standard loops and stand-ard 12 lead ECG recordings were analysed by 3 experienced cardiologists. Results: Of 129 patients, sclerosis of the sinus of valsalva was detected in 72 (55.8%), 39 (30.2%) had aortic valve sclerosis and 67 (51.9%) showed plaques of at least grade I in the ascending aorta. Conduction abnormalities and arrhythmias were found in 63 patients amongst others 30 with grade I, or higher AV-block, 10 patients with sinus node dysfunction, and 20 with atrial fibrillation. Sclerosis of the sinus of valsalva occurred in 42 of these 63 patients (p=0.022). Of 30 patients with AV-block grade I or higher, 26 presented a sinus valsalva sclerosis (p<0.001), 7 of 10 patients with sinus node dysfunction presented a sinus valsalva sclerosis (p=0.508) and 15 of 20 with atrial fibrillation (p=0.081). Conclusion: Sclerosis of the sinus of valsalva is associated with atrioventricular conduction abnormalities. atrioventricular sinus area who underwent aortic valve replacement surgery are significantly more likely to need temporary cardiac pacing than those without annular calcification [8]. We analysed TEE loops and standard 12-lead ECGs of 129 consecutive patients, undergoing cardiologic work-up after TIA/ stroke, for sclerosis of the sinus of Valsalva and the presence of conduction abnormalities such as atrioventricular blockage (AVB), right bundle branch blockage (RBB), left bundle branch blockage (LBB) and sinus node disease (SND). Materials and Methods Patient population and patient baseline characteristics We retrospectively analysed TEE studies and standard 12-lead ECGs of 129 consecutive patients at the Cardiology division of a tertiary care regional hospital in the greater Zurich area. Patient records were analysed for demographics, co-morbidities at or before the examination date, cardiovascular risk factors, and cardiovasculardrug therapy. Patients undergoing TEE for endocarditis evaluation or with congenital heart disease were excluded. The cantonal ethics committee of Zurich acknowledged retrospective data analysis for research purposes (KEK-ZH-Nr. 2014-0529). To characterize the study population and to identify a potential correlation between arrhythmias and sinus valsalva sclerosis, the following parameters were tabled as baseline characteristics: Age, BMI, heart disease divided in coronary heart disease (1-, 2or 3vessel), dilated cardiomyopathy and valvular cardiomyopathy, dyslipidaemia, smoking, type II diabetes mellitus, hypertension, history of ST-elevation myocardial infarction, cerebrovascular insult, transient ischemic attack, peripheral arterial occlusive disease, Susanne Markendorf1, Tobias Fuchs1, Dominik Mueller1, Heiner Vontobel, Urs Eriksson1,3, and Nazmi Krasniqi1,2* 1Division of Cardiology, GZO – Zurich Regional Health Center, Wetzikon, Switzerland 2Cardiology, Cardiovascular Center, University Hospital Zurich, Switzerland 3Cardioimmunology, Center of Molecular Cardiology, University of Zurich, Switzerland *Address for Correspondence Nazmi Krasniqi, MD, Division of Cardiology, GZO – Zurich Regional Health Center, Spitalstrasse 66, CH-8620 Wetzikon, Switzerland, Tel: ++41-44934-2352; Fax: ++41-44-934-1199; E-mail: nazmi.krasniqi@gzo.ch Submission: 07 July, 2015 Accepted: 18 December, 2015 Published: 23 December, 2015 Copyright: © 2015 Markendorf S et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Reviewed & Approved by: Dr. MacArthur A Elayda, Department of Cardiovascular Epidemiology and Medical Infor-matics, Texas Heart Institute, USA Case Report Open Access Journal of Cardiobiology

Sinus of Valsalva Sclerosis is Associated with Conduction Abnormalities on 12-Lead Standard ECG