Relation of nonobstructive aortic valve calcium to carotid arterial atherosclerosis

Adler, Yehuda; Levinger, Uriel; Koren, Amir; Tanné, David; Fink, Noam; Vaturi, Mordehay; Iakobishvili, Zaza; Battler, Alexander; Zelikovski, A; Sagie, Alex

doi:10.1016/s0002-9149(00)01167-x

Cited by 25 publications

(20 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is no less well documented that AV calcification is related to atherosclerosis risk factors, 2 aortic 3 and carotid atheroma, 38 and CHD 39 than it is for MAC. But the failure to detect an AV sclerosis-stroke relationship in this study could be attributable not to a difference in kind, but of degree.…”

Section: Discussionmentioning

confidence: 99%

Mitral Annular Calcification, Aortic Valve Sclerosis, and Incident Stroke in Adults Free of Clinical Cardiovascular Disease

Kizer

Wiebers

Whisnant

et al. 2005

Stroke

158

View full text Add to dashboard Cite

Background and Purpose-Mitral annular calcification (MAC) and aortic valve (AV) sclerosis have each been linked to cardiovascular disease. Whether MAC and AV sclerosis are risk factors for stroke independent of other echocardiographic or laboratory predictors has not been established. We evaluated the relationship between MAC, AV sclerosis, and first stroke events in a population-based cohort. Methods-Our study cohort consisted of 2723 American Indians participating in the Strong Heart Study who were free of prevalent cardiovascular disease. Participants underwent standardized clinical, echocardiographic, and laboratory evaluation, and incident stroke was ascertained using validated methods. Results-During a median follow-up of 7 years, 86 strokes occurred. Age-and sex-adjusted incidence rates of stroke were significantly increased for MAC (rate ratio [RR], 3.12; 95% CI, 1.77 to 5.25) but not for AV sclerosis (RR, 1.15; 95% CI, 0.45 to 2.49). MAC was also associated with a reduced time to first stroke events after adjustment for clinical variables and the inflammatory markers C-reactive protein and fibrinogen (hazard ratio [HR], 2.42; 95% CI, 1.39 to 4.21) or the echocardiographic covariates left ventricular hypertrophy and left atrial enlargement (HR, 1.89; 95% CI, 1.04 to 3.41). Individuals with and without AV sclerosis showed no significant difference in stroke-free survival in unadjusted analyses (Pϭ0.698). Crossing of the survival curves precluded multivariable analysis using Cox models. Conclusions-In this cohort of American Indians without clinical cardiovascular disease, the presence of MAC, but not AV sclerosis, proved to be a strong risk factor for incident stroke after extensive adjustment for other predictors. Individuals exhibiting MAC may benefit from aggressive risk factor modification, but this will require further investigation. (Stroke. 2005;36:2533-2537.)Key Words: calcium Ⅲ echocardiography Ⅲ heart valves Ⅲ stroke M itral annular calcification (MAC) is characterized by calcium and lipid deposition in the annular fibrosa of the mitral valve, whereas aortic valve (AV) sclerosis results from similar accumulation involving the AV leaflets. 1 Clinical precursors of atherosclerosis are also risk factors for MAC and AV sclerosis, 2,3 and the 2 conditions often exist concurrently. 2 Each, in turn, has been documented to be an independent predictor of cardiovascular events. 4,5 Several, 6,7 although not all, 8,9 studies have detailed a similar relationship between MAC and stroke, but an independent association between AV calcification and cerebral infarction has only been demonstrated in the presence of AV stenosis. 5,10,11 MAC and AV sclerosis are associated with atherosclerosis risk factors that can promote left ventricular (LV) hypertrophy and left atrial (LA) enlargement, each of which has been reported to predict cerebrovascular events. 12,13 However, available studies linking valvular calcification with cerebral ischemia have adjusted only partly, if at all, for these concurrent echocardiographi...

show abstract

Section: Discussionmentioning

confidence: 99%

Mitral Annular Calcification, Aortic Valve Sclerosis, and Incident Stroke in Adults Free of Clinical Cardiovascular Disease

Kizer

Wiebers

Whisnant

et al. 2005

Stroke

158

View full text Add to dashboard Cite

show abstract

“…[14][15][16][17] Previous studies have correlated atherosclerosis in different arterial districts, 18,19 and others have documented an association between degenerative lesions of cardiac valves and atherosclerosis in various arterial sites. 20,21 Accordingly, we observed a relation between aortic valve sclerosis and coronary atherosclerosis. Patients with sclerosis of the aortic valve have a 3.3 risk for CAD compared with patients with normal valves, independent of age.…”

Section: Discussionmentioning

confidence: 74%

Association of aortic valve sclerosis and coronary artery disease in patients with severe nonischemic mitral regurgitation

Rossi

Bertagnolli

Cicoira

et al. 2003

Clinical Cardiology

View full text Add to dashboard Cite

Background: The presence of aortic valve sclerosis accounts for a higher rate of ischemic events and increased cardiovascular mortality. It may reflect coronary artery disease (CAD) because of a shared pathologic background. Hypothesis: We aimed to analyze whether the presence of aortic valve sclerosis might help in identifying patients with coronary atherosclerosis among those with severe nonischemic mitral regurgitation (MR), who undergo coronary angiography before surgery for screening, and not because of suspected ischemic heart disease. Methods: In all, 84 patients (mean age 64 ± 9 years; 71% men) with mitral valve prolapse and severe regurgitation underwent echocardiography and coronary angiography. Aortic valve sclerosis was defined as focal areas of increased echogenicity and thickening of the leaflets without restriction of leaflet motion on echocardiography. Coronary artery disease was defined by the presence/absence of atherosclerotic plaques, independent of the degree of stenosis. Results: Coronary artery disease was diagnosed in 47.6% of patients with and 15.8% of those without aortic valve sclerosis (p = 0.008). On logistic regression analysis, the presence of aortic valve sclerosis predicted CAD (odds ratio 3.3,95% confidence interval 1.03‐10.5; p = 0.04) independent of age. In female patients, the risk ratio for CAD in the presence of aortic valve sclerosis was 9. Conclusions: Coronary artery atherosclerosis and aortic valve sclerosis are closely associated in patients with severe nonischemic MR.

show abstract

“…Calcifications of the mitral and aortic valves are also associated with carotid atherosclerosis, and may represent widespread systemic atherosclerosis [14,15]. As opposed to aortic atheromas, calcification was as prevalent in the ascending as in the descending aorta.…”

Section: Discussionmentioning

confidence: 99%

Calcification of the thoracic aorta by spiral computed tomography among hypertensive patients: Associations and risk of ischemic cerebrovascular events

Tanné

Tenenbaum

Shemesh

et al. 2007

International Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

Relation of nonobstructive aortic valve calcium to carotid arterial atherosclerosis

Cited by 25 publications

References 26 publications

Mitral Annular Calcification, Aortic Valve Sclerosis, and Incident Stroke in Adults Free of Clinical Cardiovascular Disease

Mitral Annular Calcification, Aortic Valve Sclerosis, and Incident Stroke in Adults Free of Clinical Cardiovascular Disease

Association of aortic valve sclerosis and coronary artery disease in patients with severe nonischemic mitral regurgitation

Calcification of the thoracic aorta by spiral computed tomography among hypertensive patients: Associations and risk of ischemic cerebrovascular events

Contact Info

Product

Resources

About