Key result
Lower vitamin D levels correlate with increased aortic valve peak flow velocity and stenosis progression.
Why the study?
The study was conducted to investigate the morphological characteristics of the aortic valve and identify factors associated with aortic valve stenosis progression in osteoporosis patients.
Does baseline aortic valve peak flow velocity and low vitamin D status predict the progression of aortic valve stenosis in osteoporosis patients on anti-resorptive therapy?
Cohort (n=10)
No
Does baseline aortic valve peak flow velocity and low vitamin D status predict the progression of aortic valve stenosis in osteoporosis patients on anti-resorptive therapy?
Effect estimate: beta -0.756 (95% CI -0.136 to -0.023)
p-value: p=0.011
In a small cohort of osteoporosis patients, higher baseline aortic valve peak flow velocity and low vitamin D status were associated with progression to moderate aortic stenosis over 2 years.
Low vitamin D was associated with higher aortic valve velocity in osteoporosis; hypothesis-generating and should not yet change practice.
Purpose The purpose of this study was to investigate the morphological characteristics of the aortic valve and identify factors associated with the progression of aortic valve stenosis (AS) in osteoporosis patients. Methods In this single-center prospective cohort study, we recruited 10 patients (mean age: 75 ± 7 years, 90% female) who were taking anti-resorptive medicines at the outpatient clinic of University of Miyazaki Hospital, Japan. Baseline assessments, including transthoracic echocardiogram, blood sampling, and dual energy X-ray absorptiometry, were performed. Follow-up assessments were conducted at 6, 12, 18, and 24 months. Results During the 2-year follow-up, three patients with aortic valve peak flow velocity (AV PFV) ≥2 m/s at baseline developed moderate AS, which is defined as AV PFV ≥3 m/s. However, seven patients with AV PFV <2 m/s did not exhibit any progression of AS. There were significant variations in terms of bone mineral density, T-score values, and biomarkers associated with bone turnover (i.e., bone alkaline phosphatase, tartrate-resistance acid phosphatase-5b) among the enrolled patients, but none of these factors were found to be associated with the progression of AS. All patients exhibited low vitamin D status, with a median level of 16.1 ng/mL (25 th percentile, 9.7 ng/mL; 75 th percentile, 23 ng/mL). The baseline levels of AV PFV values were negatively correlated with 25-hydroxyvitamin D levels, determined by univariate linear regression analysis (beta coefficient = -0.756, 95% confidence interval, -0.136 ̶ -0.023, p = 0.011). Conclusion Our data suggest that low vitamin D status might be a potential risk factor for the progression of AS in osteoporosis patients undergoing treatment with anti-resorptive medicines. Summary Elderly patients with osteoporosis patients exhibited a subset of aortic valve stenosis. Our data suggest that the baseline aortic valve peak flow velocity predicts the progression of aortic valve stenosis, and there might be an association between the progression and the co-existing low vitamin D status in these patients.
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Tsuruda et al. (2023) conducted a cohort in Osteoporosis and aortic valve stenosis (n=10). Anti-resorptive therapy (bisphosphonate or denosumab) was evaluated on Correlation between baseline 25-hydroxyvitamin D levels and aortic valve peak flow velocity (beta -0.756, 95% CI -0.136 to -0.023, p=0.011). Baseline aortic valve peak flow velocity was negatively correlated with 25-hydroxyvitamin D levels (beta -0.756), suggesting low vitamin D status may link to aortic valve stenosis progression.
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