Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation

Chandra, Harish; Goldstein, James A.; Choudhary, Nivedita; O'Neill, Christina; George, Peter; Gangasani, Sreenivasulu R.; Cronin, Lynn; Marcovitz, Pamela A.; Hauser, Andrew M.; O’Neill, William W.

doi:10.1016/j.jacc.2003.08.036

Cited by 102 publications

(87 citation statements)

References 26 publications

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“…These studies have consistently suggested that determination of AVCS by CT has a good correlation with the severity of aortic stenosis. [11][12][13] After this, several studies also suggested that the severity of aortic sclerosis 2) and AVCS in aortic stenosis, 14) respectively, could be used as predictors of adverse cardiovascular events. These fi ndings were explained by the fact that aortic sclerosis and coronary artery calcifi cation shared the common risk factors of atherosclerosis, 4,15) and the disease spectrum of sclerosis to stenosis in the aortic valve was akin to the process of coronary atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

“…Some epidemiologic studies have suggested that aortic sclerosis has clinical value regarding the prediction of adverse cardiovascular outcomes, 2,3) and these suggestions are evidenced by common risk factors and histologic characteristics of atherosclerosis. 4) However, the defi nition of aortic sclerosis is obscure and its qualitative nature which depends on a subjective description by echocardiography, such as focal thickening or increased echogenicity, 5) makes limitations on clinical application.…”

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confidence: 99%

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Aortic Valve Calcium Score Is Associated With Coronary Calcified Plaque Burden

Ann

Jung

et al. 2013

Int. Heart J.

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SummaryThe aim of this study was to investigate the association between the aortic valve calcium score (AVCS) and the coronary plaque burden using 64-slice multi-detector computed tomography (MDCT). Calcification of the aortic valve without signifi cant aortic stenosis itself has been suggested to be a marker of atherosclerosis. In this study, we attempted to identify a quantitative correlation between AVCS and the coronary plaque burden assumed by the Gensini score. We retrospectively evaluated 200 patients (aged 40 -88 years) who underwent MDCT and coronary angiography for chest pain. After exclusion of an aortic stenosis (peak velocity ≥ 2.0 m/s), the plaque burden of the coronary artery was determined by the Gensini score based on the plaque composition (calcifi ed, mixed, or noncalcifi ed plaque) of the CT angiogram. The calcifi c aortic valve group (AVCS > 0) showed no signifi cant difference in the total plaque burden compared to the noncalcifi c aortic valve group (AVC = 0) (Gensini score 23.6 ± 15.1 versus 21.2 ± 17.5, P = 0.31). However, the calcifi ed plaque burden was higher in the calcifi c aortic valve group (Gensini score by calcifi ed plaque 9.1 ± 10.4 versus 5.5 ± 8.6, P = 0.008). In the subgroup of patients who had an AVCS of more than 90.0 (upper 75th percentile, n = 20), the AVCS showed a more signifi cant correlation with the Gensini score by calcifi ed plaque (r = 0.618, P < 0.01). Our results suggest that a high level of AVCS is associated with the calcifi ed plaque burden of the coronary artery rather than the total plaque burden. (Int Heart J 2013; 54: 355-361)

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Aortic Valve Calcium Score Is Associated With Coronary Calcified Plaque Burden

Ann

Jung

et al. 2013

Int. Heart J.

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“…Rather than adverse outcomes as a consequence of the primary valvular disorder, it has been proposed that aortic sclerosis may represent a surrogate marker either for underlying atherosclerotic disease 44,45 or some generalized systemic process, such as inflammation. [45][46][47][48] Supporting evidence for a surrogate marker for atherosclerosis comes from the cardiac catheterization laboratory, where up to 50% of patients with severe aortic stenosis undergoing preoperative evaluation for valve replacement are diagnosed with concurrent significant coronary artery disease.…”

Section: Clinical Outcomes In Adults With Aortic Sclerosismentioning

confidence: 99%

Spectrum of Calcific Aortic Valve Disease

2005

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“…Attention has recently been focused on the inflammatory reaction as a factor for predicting the risk to the cardiovascular system. [1][2][3] It has been reported that the use of highly sensitive C-reactive protein (hs-CRP), an inflammatory marker, facilitated the quantitative measurement of CRP at a higher sensitivity, even if the CRP levels measured by using conventional methods appeared to remain within the normal range. [4][5][6][7][8][9] In addition, the risk of initially developing myocardial infarction has been reported to increase significantly with the elevation of the hs-CRP levels.…”

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confidence: 99%

Association of Inflammatory Marker and Highly Sensitive C-Reactive Protein With Aerobic Exercise Capacity, Maximum Oxygen Uptake and Insulin Resistance in Healthy Middle-Aged Volunteers

Kondo

Nomura²,

Nakaya³

et al. 2005

Circ J

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performed. These examinations consisted of medical examinations, the administration of a questionnaire on physical activity, and an exercise test to evaluate aerobic exercise capacity. Based on the results of these evaluations, indusCirc J 2005; 69: 452 -457 (Received November 12, 2004; revised manuscript received January 17, 2005; accepted January 28, 2005 Background Increased levels of inflammation markers, such as C-reactive protein (CRP) and tumor necrosis factor-, have been found in insulin resistance syndrome. Those with elevated levels of high-sensitive CRP (hs-CRP) are at a higher risk for coronary heart disease. In the present study, we evaluated whether maximum oxygen uptake and insulin resistance are related to hs-CRP for the primary prevention of coronary heart disease. Methods and ResultsThe subjects were 50 subjects who did not have diabetes mellitus. A multi-step treadmill exercise test was performed to obtain the maximum oxygen uptake when assessed by computerized breathby-breath analysis. As an index of insulin resistance, the homeostasis model insulin resistance index (HOMA-R; fasting glucose × fasting insulin/405) was used. In addition, bodyweight, body mass index, subcutaneous fat thickness, total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride were measured. Multivariate analysis revealed that hs-CRP was significantly correlated with HDL-cholesterol, uric acid, -glutamyl transpeptidase and maximum oxygen uptake. The maximum oxygen uptake showed the smallest odds ratio was in terms of the relationship with hs-CRP. Conclusions The present study suggests that the development of exercising habits increases the maximum oxygen uptake. Furthermore, an elevated maximum oxygen uptake decreases HOMA-R and reduces the inflammatory marker CRP, suggesting that exercising habit plays an important role in the primary prevention of coronary heart disease. (Circ J 2005; 69: 452 -457)

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Adverse outcome in aortic sclerosis is associated with coronary artery disease and inflammation

Abstract: The increased incidence of adverse cardiovascular events in patients with aortic sclerosis is associated with coronary artery disease and inflammation, not a result of the effects of valvular heart disease per se.

Cited by 102 publications

References 26 publications

Aortic Valve Calcium Score Is Associated With Coronary Calcified Plaque Burden

Aortic Valve Calcium Score Is Associated With Coronary Calcified Plaque Burden

Spectrum of Calcific Aortic Valve Disease

Association of Inflammatory Marker and Highly Sensitive C-Reactive Protein With Aerobic Exercise Capacity, Maximum Oxygen Uptake and Insulin Resistance in Healthy Middle-Aged Volunteers

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