Aortic valve calcification: determinants and progression in the population.
BACKGROUND
Aortic valve calcification (AVC) is considered degenerative. Recent data suggested links to atherosclerosis or coronary disease (CAD).


RESULTS
AVC and coronary artery calcifications (CAC) were prospectively assessed by Electron-Beam-Computed-Tomography in 262 population-based research participants > or = 60 years. AVC was frequent (27%) with aging (P<0.01) and in men (P<0.05). AVC was associated with diabetes, hypertension, higher body-mass-index, and serum glucose (all P<0.05). AVC was a marker of higher prevalence (P<0.01) and severity of CAD (CAC score: 441+/-802 versus 265+/-566, P<0.05) independently of age. After follow-up of 3.8+/-0.9 years, AVC score increased (94+/-271 versus 54+/-173, P<0.01, +11+/-32 U/year), faster with higher baseline AVC score (P<0.01). Compared with participants remaining free of AVC, de novo acquisition of AVC was associated with higher LDL-cholesterol (141+/-31 versus 121+/-27 mg/dL, P<0.05) and faster CAC progression (+78+/-87 versus +28+/-47 U/year, P<0.05). In multivariate analysis, LDL-cholesterol independently determined AVC acquisition while higher baseline AVC scores determined faster progression of existing AVC.


CONCLUSIONS
In the population, AVC is frequent with aging and atherosclerotic risk factors. AVC is a marker of subclinical CAD. AVC is progressive, appearing de novo with progressive atherosclerosis whereas established AVC progresses independently of atherosclerotic risk factors and faster with increasing initial AVC loads.
Messika-Zeitoun
David
D
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Bielak
Lawrence F
LF
Peyser
Patricia A
PA
Sheedy
Patrick F
PF
Turner
Stephen T
ST
Nkomo
Vuyisile T
VT
Breen
Jerome F
JF
Maalouf
Joseph
J
Scott
Christopher
C
Tajik
A Jamil
AJ
Enriquez-Sarano
Maurice
M
D017677:Age Distribution; D000368:Aged; D001021:Aortic Valve; D002114:Calcinosis / Q000175:diagnosis* / Q000453:epidemiology*; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D018450:Disease Progression; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed