Key result
Severe cardiac valve calcification is linked to ~3-fold higher cIMT.
Why the study?
Mitral annular calcification and aortic annular calcification may represent manifestations of generalized atherosclerosis, but their relationship with carotid intima media thickness is unclear.
Cross-Sectional (n=102)
No
Absolute Event Rate: 12.9% vs 3.9%
p-value: p=<0.0001
Valve calcifications may mark higher carotid atherosclerotic burden; cross-sectional data leave open causality and need for prospective validation.
BACKGROUND: Mitral annular calcification (MAC) and aortic annular calcification (AVC) may represent a manifestation of generalized atherosclerosis in the elderly. Alterations in vascular structure, as indexed by the intima media thickness (IMT), are also recognized as independent predictors of adverse cardiovascular outcomes. AIM: To examine the relationship between the degree of calcification at mitral and/or aortic valve annulus and large artery structure (thickness). METHODS: We evaluated 102 consecutive patients who underwent transthoracic echocardiography and carotid artery echoDoppler for various indications; variables measured were: systemic blood pressure (BP), pulse pressure (PP=SBP-DBP), body mass index (BMI), fasting glucose, total, HDL, LDL chlolesterol, triglycerides, cIMT. The patients were divided according to a grading of valvular/annular lesions independent scores based on acoustic densitometry: 1 = annular/valvular sclerosis/calcification absence; 2 = annular/valvular sclerosis; 3 = annular calcification; 4 = annular-valvular calcification; 5 = valvular calcification with no recognition of the leaflets. RESULTS: Patient score was the highest observed for either valvular/annulus. Mean cIMT increased linearly with increasing valvular calcification score, ranging from 3.9 +/- 0.48 mm in controls to 12.9 +/- 1.8 mm in those subjects scored 5 (p < 0.0001). In the first to fourth quartile of cIMT values the respective maximal percentual of score were: score 1: 76.1%, score 2: 70.1%, score 4: 54.3% and score 5: 69.5% (p > 0.0001). CONCLUSION: MAC and AVC score can identify subgroups of patients with different cIMT values which indicate different incidence and prevalence of systemic artery diseases. This data may confirm MAC-AVC as a useful important diagnostic parameter of systemic atherosclerotic disease.
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Sgorbini et al. (2004) conducted a cross-sectional in Atherosclerosis (Mitral/Aortic Calcification and Carotid Intima Media Thickness) (n=102). Mitral and/or aortic valve annulus calcification (MAC and AVC) score vs. Score 1 (absence of annular/valvular sclerosis/calcification) was evaluated on Mean carotid intima media thickness (cIMT) (p=<0.0001). Mitral and aortic valve calcification scores were strongly associated with increased carotid intima-media thickness, which ranged from 3.9 mm in controls to 12.9 mm in patients with severe calcification (p < 0.0001).
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