Association of aortic valve calcification to the presence, extent, and composition of coronary artery plaque burden: From the Rule Out Myocardial Infarction using Computer Assisted Tomography (ROMICAT) trial

Mahabadi, Amir A.; Bamberg, Fabian; Toepker, Michael; Schlett, Christopher L.; Rogers, Ian S.; Nagurney, John T.; Brady, Thomas J.; Hoffmann, Udo; Truong, Quynh A.

doi:10.1016/j.ahj.2009.07.027

Cited by 32 publications

(30 citation statements)

References 29 publications

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“…AVC scores increased faster with higher baseline AVC score, showing that calcium begets calcium in the aortic valve as well as arteries 87 . similar results were seen in symptomatic patients, with a significant association between prevalence of AVC and prevalence of aortic calcification and CAC and extent of CAC 88,89,90,91 . A smaller study found no correlation between baseline AVC and CAC although there was a significant correlation between the extent of annual progression of CAC and AVC 92 .…”

Section: Aortic Valvesupporting

confidence: 70%

“…A number of authors have linked the development of valvular calcification to atherosclerosis, citing the fact that both are actively regulated processes with histological, risk factor and CV outcome similarities 129,130,131,132,133,134,135,136,137,138,139 . Furthermore, takasu et al noted that all patients with progression of AVC had progression of CAC, while 80% of those with stabilisation of AVC also had stable CAC, indicating parallel development 140 .…”

Section: Valvular Calcification -Discussionmentioning

confidence: 99%

“…Age is an independent predictor of AVC presence in most studies 94,95,96,97,98,99,100,101 , but does not appear to be predictive of progression , . Prevalence rates between AVC and CAC grew more similar with age in asymptomatic subjects, with CAC appearing around seven years before AVC .…”

Section: Aortic Valvementioning

confidence: 99%

“…CAC has been much studied as an entity in itself, while calcification of other arteries and cardiac valves has been considered of less direct clinical value, despite potential relationships between them. Aortic valve calcification (AVC) is the most frequent cause of aortic stenosis in the west and is an actively regulated process 2 , while mitral annular calcification (MAC) is a degenerative process that can occasionally have serious clinical consequences, such as mitral stenosis, cerebral emboli, arrhythmia and bacterial endocarditis 3 . this article examines the pattern of relationships between CAC and calcification of other arteries and the aortic and mitral valves.…”

Section: Introductionmentioning

confidence: 99%

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Correlation between coronary and valve calcification: Review of current evidence

Nicoll¹

2015

ICFJ

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We carried out a review of the correlation between calcification of different arteries and valves and their risk factors to determine the extent of the association. We found a strong correlation between calcification presence, extent and progression between different arterial beds and the aortic valve, suggesting that calcification is a systemic diffuse disease, affecting the arterial tree as a whole. Despite this strong association, a comparison between coronary artery calcification (CAC) and calcification of other arteries may not be strictly valid, since only intimal calcification is seen in the coronary artery while other arteries may also contain medial calcification, with current scanning modalities being incapable of detecting the difference. Furthermore the pathogenesis of each type may be different.Calcification seems to appear first in the coronary artery in younger adults but may be more prevalent in the aorta in the elderly, although the incidence is notably higher in the abdominal aorta among women. Mitral annulus calcification (MAC) occurs less frequently than aortic valve calcification (AVC) in asymptomatic subjects only. MAC is correlated with calcification of the aorta and advanced MAC is found with higher CAC but there is little relationship with AVC and calcification of other arterial beds. As with the coronary artery, in the aorta and aortic valve, calcium begets calcium. Although age, male gender and possibly systolic hypertension are most frequently associated with arterial calcification, there is little consistency for other conventional risk factors and MAC andabdominal aortic calcification may be more prevalent among postmenopausal women. When the presence of CAC is factored in as a risk factor for calcification of the other arteries, multivariate analysis shows no additional significant risk factors except age.Although AVC has been viewed as a cardiac manifestation of atherosclerosis, we found little evidence to suggest that this is also true of MAC.

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Section: Aortic Valvesupporting

confidence: 70%

Section: Valvular Calcification -Discussionmentioning

confidence: 99%

Section: Aortic Valvementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correlation between coronary and valve calcification: Review of current evidence

Nicoll¹

2015

ICFJ

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“…moving parts increase the risk of stroke and death by 17-fold). AA is often associated with atherosclerosis in other vascular beds such as the carotid artery and coronary arteries [3]; an association with severe calcific aortic stenosis and mitral annular calcification has also been observed. These conditions are predisposed to embolisms and therefore aortic atheroma may be a marker of other disease states causing stroke [4,5].…”

Section: Case Reportmentioning

confidence: 99%

A drastic complex atheromatous aorta A case report

Bonadei

Vizzardi

D’Aloia

et al. 2015

Monaldi Arch Chest Dis

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We describe a case of a 70-year-old male who came to the emergency room due to dyspnea and cough despite antibiotic therapy for about one week. Chest X-ray showed moderate right pleural effusion associated with signs of pulmonary stasis and calcifications of the aorta. His history included hypertension (treated with beta-blockers) smoking and alcohol abuse. The patient was transferred to our Department and was started on therapy with boluses of intravenous diuretics. An ARB was introduced for better blood pressure control and progressive improvement of dyspnea. However, during hospitalization, the patient had an onset of angina with evidence of ST depression and onset of negative T waves in V5-V6 on electrocardiogram performed. He was submitted to trans thoracic echocardiogram which showed a dilated left ventricle with akinesia of the anterior and inferior mid-basal segments and basal septal walls determining moderate global systolic dysfunction (ejection fraction 35%-40%) and evidence of aortic stenosis. There was a modest increase in the markers of myocardial necrosis. So we began double antiplatelet therapy and intravenous nitrates added to 20 mg of simvastatin and it was planned the coronary angiography. Meanwhile, for the detection of marked bradycardia and some episodes of asystole on telemetry ( Figure 1) the patient was transferred to our intensive care unit and it was implanted temporary pacemaker. Coronary angiography detected moderate coronary artery disease: moderate stenosis of the proximal left anterior descending coronary and to ostial of right coronary artery (RCA); before a revascularization procedure we planned a study of myocardial viability in the territory of the RCA. Returning from the hemodynamic room the patient reported the onset of temporary phosphenes in the right eye. He was evaluated by a neurologist who suggested a retinal periprocedural microembolism. Another echocardiogram was performed which confirmed what had been revealed earlier. However moderate aortic calcified stenosis was noted (delta P max 35-40 mm Hg, AVA 1.5 -1.6 cm2), subsequently confirmed by transesophageal echocardiograpy (TEE) (Figure 2). It also showed the presence of a marked atherosclerotic aortic wall associated with moving parts floating in the descending aorta that were not present in the aortic arch ( Figure 3). The patient was treated with heparin, enhanced antihypertensive therapy and simvastatin was replaced with 40 mg of atorvastatin. Due to the onset of inflammation, the assessment for possible revascularization and implantation of pacemaker was delayed. During the subsequent hospitalization, the patient began complaining of a stabbing pain and cramping of the left lower limb, associated with absence of peripheral pulses and hypothermia. A vascular surgeon was contacted who raised the suspicion of acute lower limb thrombotic and embolic ischemia. The patient underwent thromboembolectomy using a Fogarty catheter followed by resumption of anticoagulation.After a few hours we noted the emergence of an acu...

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Aortic valve and aortic root calcifications for predicting major adverse cardiovascular events: NADESICO study

et al. 2022

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Association of aortic valve calcification to the presence, extent, and composition of coronary artery plaque burden: From the Rule Out Myocardial Infarction using Computer Assisted Tomography (ROMICAT) trial

Cited by 32 publications

References 29 publications

Correlation between coronary and valve calcification: Review of current evidence

Correlation between coronary and valve calcification: Review of current evidence

A drastic complex atheromatous aorta A case report

Aortic valve and aortic root calcifications for predicting major adverse cardiovascular events: NADESICO study

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