Aortic Valve Calcification and Risk of Stroke

Bos, Daniël; Bozorgpourniazi, Atefeh; Mutlu, Ünal; Kavousi, Maryam; Vernooij, Meike W.; Moelker, Adriaan; Franco, Oscar H.; Koudstaal, Peter J.; Ikram, M. Arfan; Lugt, Aad van der

doi:10.1161/strokeaha.116.015200

Cited by 14 publications

(9 citation statements)

References 16 publications

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“…Intracranial carotid artery calcification (ICAC) and vertebrobasilar artery calcification (VBAC) were quantified using a semiautomatic scoring method that allows to manually segment calcification in each consecutive CT slice after which the calcification volume is computed using the pixel size and the increment [ 2 , 19 , 20 ]. A detailed description of the evaluation methods is provided elsewhere [ 2 , 3 , 19 – 21 ].…”

Section: Methodsmentioning

confidence: 99%

Arterial calcification at multiple sites: sex-specific cardiovascular risk profiles and mortality risk—the Rotterdam Study

Toorn

Rueda‐Ochoa

Schaft

et al. 2020

BMC Med

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Background Evidence has pointed towards differences in the burden of arteriosclerosis according to its location and sex. Yet there is a scarcity of population-based data on aggregated sex-specific cardiovascular risk profiles, instead of single risk factors, and mortality risk according to the location of arteriosclerosis. We assessed sex-specific cardiovascular risk profiles and mortality risk associated with arteriosclerosis. Methods From the population-based Rotterdam Study, 2357 participants (mean age 69 years, 53% women) underwent non-contrast computed tomography to quantify calcification, as a proxy for arteriosclerosis, in the coronary arteries (CAC), aortic arch (AAC), extracranial (ECAC) and intracranial carotid arteries (ICAC), vertebrobasilar arteries (VBAC), and aortic valve (AVC). Principal component analysis (PCA) of eight distinct cardiovascular risk factors was performed, separately for women and men, to derive risk profiles based on the shared variance between factors. We used sex-stratified multivariable logistic regression to examine the associations between PCA-derived risk profiles and severe calcification at different locations. We investigated the associations of severe calcification with mortality risk using sex-stratified multivariable Cox regression. Results PCA identified three cardiovascular risk profiles in both sexes: (1) anthropometry, glucose, and HDL cholesterol; (2) blood pressure; and (3) smoking and total cholesterol. In women, the strongest associations were found for profile 2 with severe ECAC and ICAC (adjusted OR [95% CI] 1.32 [1.14–1.53]) and for profile 3 with severe at all locations, except AVC. In men, the strongest associations were found for profile 2 with VBAC (1.31 [1.12–1.52]) and profile 3 with severe AAC (1.28 [1.09–1.51]). ECAC and AVC in women and CAC in men showed the strongest, independent associations with cardiovascular mortality (HR [95% CI] 2.11 [1.22–3.66], 2.05 [1.21–3.49], 2.24 [1.21–3.78], respectively). Conclusions Our findings further underline the existence of sex- and location-specific differences in the etiology and consequences of arteriosclerosis. Future research should unravel which distinct pathological processes underlie differences in risk profiles for arteriosclerosis.

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Section: Methodsmentioning

confidence: 99%

Arterial calcification at multiple sites: sex-specific cardiovascular risk profiles and mortality risk—the Rotterdam Study

Toorn

Rueda‐Ochoa

Schaft

et al. 2020

BMC Med

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“…Main findings in recent years with respect to stroke and Alzheimer’s disease, include the study of the following determinants: cerebral perfusion [ 252 ], thyroid function [ 189 ], aortic valve calcification [ 253 ], white matter microstructure [ 254 ], orthostatic hypotension [ 255 ], mid-life blood pressure [ 256 ], depression [ 257 ], and parental family history [ 258 ].…”

Section: Neurological Diseasesmentioning

confidence: 99%

“…Important new reports describe the determinants of overall plaque burden and how plaque composition relates to a history of stroke [ 465 , 466 ]. In recent years, we have expanded our interest in imaging markers of cardiovascular disease towards epicardial fat [ 467 , 468 ] and aortic valve calcification [ 253 , 469 ].…”

Section: Imaging Studiesmentioning

confidence: 99%

The Rotterdam Study: 2018 update on objectives, design and main results

et al. 2017

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The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. Since 2016, the cohort is being expanded by persons aged 40 years and over. The findings of the Rotterdam Study have been presented in over 1500 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.

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“…Progression of AVC is not significantly associated with stroke but with progression of mitral annular calcification (MAC) [53]. Other studies showed that there is no association between AVC and increased risk of stroke [54] or dementia [55]. Adler et al [56] in their study confirmed that presence of AVC increases odds of death from CVD causes.…”

Section: Discussionmentioning

confidence: 93%

Aortic Valve Calcification Score in Patients with Arterial Hypertension Environmentally Exposed to Tobacco Smoke

et al. 2021

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The objective of our study was to determine the relationship between exposure to environmental tobacco smoke (ETS) and the value of the aortic valve calcification score (AVCS) in people suffering from arterial hypertension (AH). 107 non-smokers with AH (mean age 67.16 ± 8.48 years) were qualified for the study. The degree of exposure to ETS was assessed using the Second-hand Smoke Exposure Scale (SHSES) questionnaire. Study group was divided depending on ETS exposure: A—no exposure, B—low, C—medium and D—high. AVCS was measured based on the aortic valve plane multiplanar reconstruction from the non-contrast phase of the cardiac computed tomography. The Agatston algorithm was used, in which calcifications were considered changes with a density exceeding 130 HU. The mean AVCS value in the study group of patients was 213.59 ± 304.86. The AVCS was significantly lower in subgroup A than in subgroups C and D. In subgroup A, the lack of aortic valve calcification (AVCS = 0) was observed significantly more frequently than in subgroups C and D. There was a positive correlation between the number of SHSES points and the AVCS value (r = 0.37, p < 0.05). Based on the ROC curve, the SHSES value was determined as the optimal cut-off point for the prediction of AVCS = 0, amounting to 3 points. The accuracy of SHSES < 3 as the predictor of AVCS = 0 was set at 62.18%. Hypertensive patients have an unfavourable relationship between the amount of exposure to ETS, determined on the SHSES scale, and the AVCS value.

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Aortic Valve Calcification and Risk of Stroke

Cited by 14 publications

References 16 publications

Arterial calcification at multiple sites: sex-specific cardiovascular risk profiles and mortality risk—the Rotterdam Study

Arterial calcification at multiple sites: sex-specific cardiovascular risk profiles and mortality risk—the Rotterdam Study

The Rotterdam Study: 2018 update on objectives, design and main results

Aortic Valve Calcification Score in Patients with Arterial Hypertension Environmentally Exposed to Tobacco Smoke

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