Pathogenesis of "senile" nodular sclerosis of atrio-ventricular valves.

Nodular thickening of the atrio-ventricular valves may be conspicuous in the hearts of the elderly. Usually described as senile sclerosis, it is assumed to be an involutional or degenerative process associated with advanced age. The difficulty of dis- tinguishing such changes from the results of other pathological conditions which may have been present earlier in life is well recognized (Gould, 1960), and some workers attribute these changes to processes other than simple ageing. Robbins (1962) included senile sclerosis as a facet of arteriosclerotic heart disease; Rezek and Millard (1963) considered it was due to previous non-specific endocarditis; and Angrist (1964) thought both these processes played a part. In the present study, necropsy material from 815 patients was examined in an attempt to evaluate the possible roles of inflammation, ageing, atheroma, hypertension, and cardiac hypertrophy in the pathogenesis of nodular sclerosis.