title: Distribution of Mitral Annular and Aortic Valve Calcium as Assessed by Unenhanced Multidetector Computed Tomography.
abstract: Aging is associated with calcium deposits in various cardiovascular structures, but patterns of calcium deposition, if any, are unknown. In search of such patterns, we performed quantitative assessment of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a broad clinical sample. Templates were created from gated computed tomography (CT) scans depicting the aortic valve cusps and mitral annular segments in relation to surrounding structures. These were then applied to CT reconstructions from ungated, clinically indicated CT scans of 318 subjects, aged ≥65 years. Calcium location was assigned using the templates and quantified by the Agatston method. Mean age was 76 ± 7.3 years; 48% were men and 58% were white. Whites had higher prevalence (p = 0.03) and density of AVC than blacks (p = 0.02), and a trend toward increased MAC (p = 0.06). Prevalence of AVC was similar between men and women, but AVC scores were higher in men (p = 0.008); this difference was entirely accounted for by whites. Within the aortic valve, the left cusp was more frequently calcified than the others. MAC was most common in the posterior mitral annulus, especially its middle (P2) segment. For the anterior mitral annulus, the medial (A3) segment calcified most often. In conclusion, AVC is more common in whites than blacks, and more intense in men, but only in whites. Furthermore, calcium deposits in the mitral annulus and aortic valve favor certain locations.
authors.affiliation: Department of Internal Medicine, Einstein Medical Center, Philadelphia, Pennsylvania.
authors.forename: Nikoloz
authors.initials: N
authors.lastname: Koshkelashvili
authors.affiliation: The Institute for Heart and Vascular Health, Department of Internal Medicine, Einstein Medical Center, Philadelphia, Pennsylvania.
authors.forename: Jose N
authors.initials: JN
authors.lastname: Codolosa
authors.affiliation: Department of Radiology, Einstein Medical Center, Philadelphia, Pennsylvania.
authors.forename: Igor
authors.initials: I
authors.lastname: Goykhman
authors.affiliation: The Institute for Heart and Vascular Health, Department of Internal Medicine, Einstein Medical Center, Philadelphia, Pennsylvania.
authors.forename: Abel
authors.initials: A
authors.lastname: Romero-Corral
authors.affiliation: The Institute for Heart and Vascular Health, Department of Internal Medicine, Einstein Medical Center, Philadelphia, Pennsylvania. Electronic address: pressmang@einstein.edu.
authors.forename: Gregg S
authors.initials: GS
authors.lastname: Pressman
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000378:metabolism; D002118:Calcium / Q000378:metabolism*; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000378:metabolism; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D061330:Multidetector Computed Tomography / Q000379:methods*; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D002118:Calcium