Osteoporosis Treatment and Progression of Aortic Stenosis

Skolnick, Adam H.; Osranek, Martin; Formica, Philip; Kronzon, Itzhak

doi:10.1016/j.amjcard.2009.02.051

Cited by 54 publications

(34 citation statements)

References 15 publications

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“…To our knowledge, this is the first study that has evaluated the association between bisphosphonate-only treatment and AS progression at different stages of the disease. The present study extends the results of Skolnick et al [14], who found slower AS progression in a retrospective analysis of 18 patients treated for osteoporosis by several pharmacologic agents with different modes of action, specifically bisphosphonates, calcitonin or estrogen receptor modulators, when compared with untreated, nonosteoporotic patients with AS.…”

Section: Discussionsupporting

confidence: 75%

Bisphosphonates in Calcific Aortic Stenosis: Association with Slower Progression in Mild Disease – A Pilot Retrospective Study

Štěrbáková

Vyskocil²,

Linhartová³

2010

Cardiology

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Objectives: An association between aortic valve calcification and osteoporosis has been observed. The aim of this study was to assess the association between bisphosphonate treatment for osteoporosis and the progression of calcific aortic stenosis (AS). Methods: A retrospective study of patients with AS (mean gradient ≧10 mm Hg), preserved renal function and two echocardiographies >8 months apart was performed. The patients were divided into those treated with bisphosphonates for osteoporosis and those not treated and then subdivided into mild (mean gradient <30 mm Hg) and moderate-to-severe AS groups. We compared the annualized gradient change between the groups and identified predictors of AS progression. Results: We analyzed the outcomes of 103 patients (51% females, age 68 ± 10 years, follow-up 29 ± 13 months), of whom 57 had mild and 46 moderate-to-severe AS. Bisphosphonates were taken by 28 patients, of whom 22 had mild and 6 moderate-to-severe AS. In the patients with mild AS, the annualized mean gradient change was lower in the bisphosphonate-treated than in the untreated patients (0.1 ± 3.3 vs. 2.8 ± 3.3 mm Hg/year; p = 0.002) and was negatively associated with bisphosphonate treatment (β coefficient –2.36%, 95% confidence interval –4.47 to –0.26; p = 0.028) independent of age, gender and baseline gradient. Conclusion: Bisphosphonate treatment was independently associated with slower progression of mild AS in patients with preserved renal function.

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Section: Discussionsupporting

confidence: 75%

Bisphosphonates in Calcific Aortic Stenosis: Association with Slower Progression in Mild Disease – A Pilot Retrospective Study

Štěrbáková

Vyskocil²,

Linhartová³

2010

Cardiology

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“…The effect of osteoporosis therapy has been investigated because of an association between aortic valve calcification and low skeletal bone mineral density (Aksoy et al, 2005). Several small observational studies demonstrated a possible link between use of bisphosphonates and slowing of AVS progression (Skolnick et al, 2009;Sterbakova et al, 2010;Innasimuthu and Katz, 2011), although such beneficial effects may be not remarkable in older women (Aksoy et al, 2012). Taken together, prospective randomized clinical studies are certainly needed to evaluate the role of regulation of calcium and phosphate metabolism for preventing progression of CAVD especially at its early stage.…”

Section: Discussionmentioning

confidence: 99%

Mineral metabolism disturbances are associated with the presence and severity of calcific aortic valve disease

Yang

Zhao

Fang

et al. 2015

J. Zhejiang Univ. Sci. B

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Abstract:Objective: We investigated whether disturbance of calcium and phosphate metabolism is associated with the presence and severity of calcific aortic valve disease (CAVD) in patients with normal or mildly impaired renal function. Methods: We measured serum levels of calcium, phosphate, alkaline phosphatase (AKP), intact parathyroid hormone (iPTH), 25-hydroxyvitamin D (25-OHD), and biomarkers of bone turnover in 260 consecutive patients with normal or mildly impaired renal function and aortic valve sclerosis (AVSc) (n=164) or stenosis (AVS) (n=96) and in 164 age-and gender-matched controls. Logistic regression models were used to determine the association of mineral metabolism parameters with the presence and severity of CAVD. Results: Stepwise increases were observed in serum levels of calcium, phosphate, AKP, and iPTH from the control group to patients with AVS, and with reverse changes for 25-OHD levels (all P<0.001). Similarly, osteocalcin, procollagen I N-terminal peptide, and β-isomerized type I collagen C-telopeptide breakdown products were significantly increased stepwise from the control group to patients with AVS (all P<0.001). In patients with AVS, serum levels of iPTH were positively, in contrast 25-OHD levels were negatively, related to trans-aortic peak flow velocity and mean pressure gradient. After adjusting for relevant confounding variables, increased serum levels of calcium, phosphate, AKP, and iPTH and reduced serum levels of 25-OHD were independently associated with the presence and severity of CAVD. Conclusions: This study suggests an association between mineral metabolism disturbance and the presence and severity of CAVD in patients with normal or mildly impaired renal function. Abnormal bone turnover may be a potential mechanism.

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“…reported the association between osteoporosis and decreased progression of aortic stenosis, and speculated inhibition of valvular calcification might be due to alterations in levels of Vitamin D and parathyroid hormone. [6] On the other hand, it is reported chronic secondary hyperparathyroidism in renal failure is associated with aortic calcification. In patients with sarcoidosis, high plasma parathyroid hormone-related peptide levels are often observed.…”

Section: Discussionmentioning

confidence: 99%

Low-gradient structural valve deterioration in a patient of cardiac sarcoidosis

Koizumi

Matsuura

Kobayashi

et al. 2017

J Cardiovasc Echography

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We report a case of structural valve deterioration, which occurred 7 years after aortic valve replacement in a 78-year-old male with cardiac sarcoidosis. His echocardiography showed low transprosthetic valve gradient and depressed left ventricular function. A dobutamine stress echocardiography was performed to identify his pathophysiology, and it revealed that his depressed left ventricular function was not due to cardiac sarcoidosis but to structural valve deterioration. Reoperation for structural valve deterioration was performed, and his left ventricular function recovered.

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Osteoporosis Treatment and Progression of Aortic Stenosis

Cited by 54 publications

References 15 publications

Bisphosphonates in Calcific Aortic Stenosis: Association with Slower Progression in Mild Disease – A Pilot Retrospective Study

Bisphosphonates in Calcific Aortic Stenosis: Association with Slower Progression in Mild Disease – A Pilot Retrospective Study

Mineral metabolism disturbances are associated with the presence and severity of calcific aortic valve disease

Low-gradient structural valve deterioration in a patient of cardiac sarcoidosis

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