Progression of valvular calcification and risk of incident stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)

Fashanu, Oluwaseun E.; Bizanti, Anas; Al‐Abdouh, Ahmad; Zhao, Di; Budoff, Matthew J.; Thomas, Isac C.; Longstreth, W. T.; Michos, Erin D.

doi:10.1016/j.atherosclerosis.2020.06.009

Cited by 16 publications

(10 citation statements)

References 25 publications

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“…These studies mainly focused on the impact of valve calcification and coronary atherosclerosis on the incidence and mortality of patients with CVD (Budoff et al, 2011). He also explored the association between VC progression and patient prognosis (Fashanu et al, 2020). We also found that the most commonly cited author was Floege J from Germany.…”

Section: General Informationmentioning

confidence: 75%

Bibliometric and Visual Analysis of Vascular Calcification Research

et al. 2021

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Background: Extensive studies related to vascular calcification (VC) were conducted in recent years. However, no bibliometric analysis has systematically investigated this topic. Our study aimed to determine the hotspots and frontiers of VC research in the past decade and provide a reference for future scientific research directions and decision-making in the VC field.Methods: VC studies were acquired from the Web of Science Core Collection. Bibliometric and visual analyses were performed using CiteSpace, VOSviewer, and Microsoft Excel software.Results: A total of 8,238 English articles on VC research published in 2011–2020 were obtained. In the past decade, annual publications and citations showed a significant growth trend, especially in 2018–2020. The most productive country, institution, journal and author are the United States, the University of California System, PLOS ONE, and Budoff MJ, respectively. The most frequently cited country, journal, and author are the United States, Journal of the American College of Cardiology, and Floege J, respectively. “Vascular calcification,” “atherosclerosis,” “chronic kidney disease,” and “cardiovascular disease” are the primary keywords. The burst keywords “revascularization,” “calciprotein particle,” “microRNA,” and “microcalcification” are speculated to be the research frontiers.Conclusion: The main research hotspots in the VC field are the molecular mechanisms and prognosis of VC in patients with chronic kidney disease or cardiovascular disease. In addition, endovascular therapy and the development of new drugs targeting signal pathways for VC will become the focus of future research. Moreover, non-coding RNAs related to the diagnosis and treatment of VC are great research prospects.

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Section: General Informationmentioning

confidence: 75%

Bibliometric and Visual Analysis of Vascular Calcification Research

et al. 2021

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“…These markers besides being atrial cardiopathy markers, also represent significant predictors of AF. Indeed, previous studies demonstrated that left atrial volume index is associated with new-onset AF and stroke recurrence in ESUS patients ( 17 ), many electrocardiographic markers of atrial cardiopathy can predict AF occurrence ( 18 ) and mitral valve calcification, even when asymptomatic, is associated with increased risk for AF ( 19 ) and stroke ( 20 ).…”

Section: Discussionmentioning

confidence: 95%

Markers of Atrial Cardiopathy in Severe Embolic Strokes of Undetermined Source

Acampa

Cartocci²,

Domenichelli³

et al. 2022

Front. Cardiovasc. Med.

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Background and PurposeThe current definition of embolic strokes of undetermined source (ESUS) seems to be too broad, including strokes due to heterogeneous mechanisms, such as atrial cardiopathy and other occult cardiac conditions, aortic arch plaques, and non-stenosing atherosclerosis, that can be differently associated with clinical stroke severity at the time of presentation. The aim of our study was to assess the possible association between neurological deficit severity and presence of markers of atrial cardiopathy in ESUS.MethodsWe retrospectively reviewed the medical records of a cohort of 226 ESUS patients (105 M, 121 F), that were divided into two groups according to the severity of neurological deficit (99 mild strokes with NIHSS ≤ 5 and 127 severe strokes with NIHSS >5). The following indices of atrial cardiopathy were evaluated: P wave dispersion, P wave max, P wave min, P wave mean, P wave index, P wave axis, left atrial size.ResultsPatients with severe ESUS were significantly older (74 ± 12 vs. 67 ± 14 years, P < 0.001) and female sex was prevalent (67 vs. 36%, P > 0.001); they had higher values of P-wave-dispersion (51 ± 14 vs. 46 ± 13, P = 0.01), P-wave-max (131 ± 20 vs. 125 ± 15 ms, P = 0.01), P-wave-index (16 ± 5 vs. 15 ± 5 ms, P = 0.01), left atrial size (20 ± 6 vs. 18 ± 4 cm2, P = 0.01), left atrial volume index (31 ± 14 vs. 27 ± 11 ml/m2, P = 0.04), in comparison with mild ESUS. An abnormal P wave axis was detected more frequently in severe ESUS (21 vs. 9%, P = 0.01). Furthermore, multivariate logistic regression showed that age (OR = 1.21 for each 5-year increase, 95% CI 1.09–1.35), sex (OR = 3.24 for female sex, 95% CI 1.82–5.76) and PWD (OR = 1.32 for each 10-ms increase, 95% CI 1.07–1.64) were the best subset of associated variables for severe ESUS.ConclusionsOur findings shed light on specific clinical characteristics of severe ESUS including the presence of atrial cardiopathy that could play a pathogenic role in this subgroup of patients. Searching for atrial fibrillation in these patients is especially important to perform the most appropriate therapy.

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“…Cardiovascular Heart Study [52], in which 5,201 people in age of at least 65 years were enrolled, showed that aortic valve disease morbidity was increased in case of AH and present smoking (20% and 35%, respectively, increase in risk). Progression of AVC is not significantly associated with stroke but with progression of mitral annular calcification (MAC) [53]. Other studies showed that there is no association between AVC and increased risk of stroke [54] or dementia [55].…”

Section: Discussionmentioning

confidence: 99%

Aortic Valve Calcification Score in Patients with Arterial Hypertension Environmentally Exposed to Tobacco Smoke

et al. 2021

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The objective of our study was to determine the relationship between exposure to environmental tobacco smoke (ETS) and the value of the aortic valve calcification score (AVCS) in people suffering from arterial hypertension (AH). 107 non-smokers with AH (mean age 67.16 ± 8.48 years) were qualified for the study. The degree of exposure to ETS was assessed using the Second-hand Smoke Exposure Scale (SHSES) questionnaire. Study group was divided depending on ETS exposure: A—no exposure, B—low, C—medium and D—high. AVCS was measured based on the aortic valve plane multiplanar reconstruction from the non-contrast phase of the cardiac computed tomography. The Agatston algorithm was used, in which calcifications were considered changes with a density exceeding 130 HU. The mean AVCS value in the study group of patients was 213.59 ± 304.86. The AVCS was significantly lower in subgroup A than in subgroups C and D. In subgroup A, the lack of aortic valve calcification (AVCS = 0) was observed significantly more frequently than in subgroups C and D. There was a positive correlation between the number of SHSES points and the AVCS value (r = 0.37, p < 0.05). Based on the ROC curve, the SHSES value was determined as the optimal cut-off point for the prediction of AVCS = 0, amounting to 3 points. The accuracy of SHSES < 3 as the predictor of AVCS = 0 was set at 62.18%. Hypertensive patients have an unfavourable relationship between the amount of exposure to ETS, determined on the SHSES scale, and the AVCS value.

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Progression of valvular calcification and risk of incident stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)

Cited by 16 publications

References 25 publications

Bibliometric and Visual Analysis of Vascular Calcification Research

Bibliometric and Visual Analysis of Vascular Calcification Research

Markers of Atrial Cardiopathy in Severe Embolic Strokes of Undetermined Source

Aortic Valve Calcification Score in Patients with Arterial Hypertension Environmentally Exposed to Tobacco Smoke

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