Association between aortic valve calcification measured on non-contrast computed tomography and aortic valve stenosis in the general population

Paulsen, Niels Herluf; Carlsen, Bjarke Bønløkke; Dahl, Jordi S.; Carter-Storch, Rasmus; Christensen, Nicolaj Lyhne; Khurrami, Lida; Møller, Jacob Eifer; Lindholt, Jes Sanddal; Diederichsen, Axel Cosmus Pyndt

doi:10.1016/j.jcct.2016.05.001

Cited by 14 publications

(9 citation statements)

References 14 publications

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“…17 Reference values are so far not applicable, but in the present study we considered values ≥300 AU of significance. 18…”

Section: Aortic Valve Calcificationmentioning

confidence: 99%

<p>Feasibility Study of Advanced Cardiovascular Screening in Middle-Aged Patients with Diabetes</p>

Lindholt¹,

Frystyk²,

Hallas³

et al. 2020

CLEP

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Purpose: Cardiovascular mortality remains high among patients with diabetes compared with the general population. The primary aim was to evaluate the interest in and demand for advanced cardiovascular screening in patients with diabetes; the secondary aim was to explore its efficiency in detecting unprotected subclinical cardiovascular disease (CVD). Patients and Methods: In a cross-sectional design, randomly selected 40-60-year-old men and women with diabetes were invited to the screening trial. Screening encompassed (1) a comprehensive medical interview; (2) non-contrast computed tomography scanning to quantify coronary artery and aortic valve calcification, to measure left atrial size, to assess heart rhythm and to detect aortic and iliac dilatations; (3) ankle and brachial blood pressure measurements; and (4) blood and urine samples for measurements of HbA 1c , lipid profile, renal function, NT-pro B-type natriuretic peptide (pro-BNP) and albuminuria. Primary outcome was participation rate; secondary outcome was rate of unprotected subclinical CVD. Results: Of 465 invited patients, 191 (41.1%) attended screening. The participation rate was 40% (95% CI:33-47) for males and 42% (95% CI:36-48) for females. Twenty-four patients were excluded due to previous CVD. The remaining patients' mean age was 52 years; 58% were males. Subclinical CVD was found in 64%, with a male preponderance (males 75% (95% CI:66-83; females 49% (95% CI:37-60)). Presence of severe coronary artery calcification (score ≥ 400) showed a male preponderance (males 19% (95% CI:12-27); females 7% (95% CI:3-16)). Aortic valve calcification, enlarged left atrial volume, atrial fibrillation, aortic dilatations, peripheral artery disease or increased pro-BNP were uncommon, and without any sex differences. Unprotected subclinical CVD was very common, and medical treatment was intensified in 60% (95% CI:53-68) of patients. Conclusion: We propose a feasible cardiovascular screening examination from which middle-aged patients with diabetes may benefit. However, the participation rate may be too low to warrant screening.

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“…17 Reference values are so far not applicable, but in the present study we considered values ≥300 AU of significance. 18…”

Section: Aortic Valve Calcificationmentioning

confidence: 99%

<p>Feasibility Study of Advanced Cardiovascular Screening in Middle-Aged Patients with Diabetes</p>

Lindholt¹,

Frystyk²,

Hallas³

et al. 2020

CLEP

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“…2 In CKD patients, valvular calcium is an important underlying mechanism of valve dysfunction. 3 Hypertension, inflammation, and dysregulated metabolic pathways, such as disorders in the calcium-phosphate metabolism, lead to the development of valvular calcium in patients with CKD. 4,5 Valvular calcium is associated with an increased risk of all-cause mortality in patients with end-stage renal disease.…”

mentioning

confidence: 99%

Prevalence and Prognostic Implications of Mitral and Aortic Valve Calcium in Patients With Chronic Kidney Disease

Hensen

Mahdiui

Rosendael

et al. 2018

The American Journal of Cardiology

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Calcium in the cardiac valves can be observed in patients with severe chronic kidney disease (CKD). However, the prevalence and prognostic implications of left-sided cardiac valve calcium in patients with stage 2 and 3 CKD (estimated glomerular filtration rate (eGFR) of 60 to 89 and 30 to 59 ml/min/1.73 m 2 respectively) is unknown. The present study investigates the prevalence of mitral and aortic valve calcium in patients with stage 2 and 3 CKD and evaluates its association with all-cause mortality. In patients with stage 2 and 3 CKD who underwent clinically indicated coronary computed tomography angiography, the presence of mitral and/or aortic valve calcium was assessed. Patients were divided into 2 groups according to the presence of mitral and/or aortic valve calcium on coronary computed tomography angiography. Patients were followed for the occurrence of all-cause mortality (primary end point). Of 204 stage 2 and 3 CKD patients (54% men, mean age 60 § 10 years), 66 (32%) patients had mitral and/or aortic valve calcium. During a median follow-up of 6 years (IQR; 2, 9 years), 29 (14%) patients died. Patients with mitral and/or aortic valve calcium showed significantly higher mortality rates compared with patients without left-sided valve calcium (log-rank p = 0.009). Mitral valve calcium was independently associated with increased risk of all-cause mortality, whereas aortic valve calcium was not. In conclusion, the prevalence of left-sided valve calcium in patients with stage 2 and 3 CKD is high. Mitral valve calcium was independently associated with increased risk of all-cause mortality, whereas aortic valve calcium was not.

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“…In DANCAVAS, we are performing echocardiography in all participants with an AVC score above the 90% percentile (AVC score above 300). 32 Patients with an AVC score above 300, but without aortic valve stenosis are eligible patients in Aortic Valve DECalcification (AVADEC) trial.…”

Section: Methodsmentioning

confidence: 99%

“… 36 The CAC score is assessed as previously described. 32 To assess the calcifications in the carotid, aortic, renal, iliac and femoral arteries, a CT scanning proximal from the mandibular bone and distally to the proximal third of the femur are performed with the following settings: spiral scan with a pitch of 3.2 (Flash), 100 kV tube voltage, 90 mAs, collimation of 128×0.6 mm, Safire 3 and slice thickness 5 mm. The calcifications scores are measured using the Agatston method.…”

Section: Applied Tests During the Studymentioning

confidence: 99%

Effects of menaquinone-7 supplementation in patients with aortic valve calcification: study protocol for a randomised controlled trial

Lindholt

Frandsen²,

Fredgart

et al. 2018

BMJ Open

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IntroductionAortic stenosis is a common heart valve disease, and due to the growing elderly population, the prevalence is increasing. The disease is progressive with increasing calcification of the valve cusps. A few attempts with medical preventive treatment have failed; thus, presently, the only effective treatment of aortic stenosis is surgery. This study will examine the effect of menaquinone-7 (MK-7) supplementation on progression of aortic valve calcification (AVC). We hypothesise that MK-7 supplementation will slow down the calcification process.Methods and analysisIn this multicenter and double-blinded, placebo-controlled study, 400 men aged 65–74 years with substantial AVC are randomised (1:1) to treatment with MK-7 (720 µg/day) supplemented by the recommended daily dose of vitamin D (25 µg/day) or placebo treatment (no active treatment) for 2 years. Exclusion criteria are treatment with vitamin K antagonist or coagulation disorders. To evaluate AVC score, a non-contrast CT scan is performed at baseline and repeated after 12 and 24 months of follow-up. Primary outcome is difference in AVC score from baseline to follow-up at 2 years. Intention-to-treat principle is used for all analyses.Ethics and disseminationThere are no reported adverse effects associated with the use of MK-7. The protocol is approved by the Regional Scientific Ethical Committee for Southern Denmark (S-20170059) and the Data Protection Agency (17/19010). It is conducted in accordance with the Declaration of Helsinki. Positive as well as negative findings will be reported.Trial registration numberNCT03243890.

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Association between aortic valve calcification measured on non-contrast computed tomography and aortic valve stenosis in the general population

Cited by 14 publications

References 14 publications

<p>Feasibility Study of Advanced Cardiovascular Screening in Middle-Aged Patients with Diabetes</p>

<p>Feasibility Study of Advanced Cardiovascular Screening in Middle-Aged Patients with Diabetes</p>

Prevalence and Prognostic Implications of Mitral and Aortic Valve Calcium in Patients With Chronic Kidney Disease

Effects of menaquinone-7 supplementation in patients with aortic valve calcification: study protocol for a randomised controlled trial

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