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Nonobstructive aortic valve calcium as a window to atherosclerosis of the aorta
1Cardiology Department, The Scheingarten Echocardiography Unit, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
Insights
Aortic valve calcium is strongly linked to aortic atheroma, a form of atherosclerosis. This finding suggests aortic valve calcium may indicate broader aortic atherosclerosis.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Atherosclerosis Research
Background:
- Aortic valve calcium (AVC) and mitral annulus calcium (MAC) correlate with atherosclerotic risk factors.
- Recent studies suggest MAC is an atherosclerotic process itself.
- The association between AVC and aortic atherosclerosis remains unclear.
Purpose of the Study:
- To investigate the relationship between AVC and aortic atheroma.
- To determine if AVC is an independent predictor of aortic atheroma.
Main Methods:
- Transesophageal echocardiography (TEE) was used to evaluate 96 patients with AVC and compare them to 92 controls.
- Aortic atheromas were assessed for presence, dimension, and complexity.
- Multivariate analysis was performed to identify independent predictors of aortic atheroma.
Main Results:
- Patients with AVC had significantly higher rates of aortic atheroma (86% vs. 30%, p=0.001).
- The dimension and complexity of atheromas were also greater in the AVC group.
- AVC and MAC were identified as independent predictors of aortic atheroma.
Conclusions:
- A significant association exists between AVC and the presence/severity of aortic atheroma.
- AVC may serve as a valuable indicator for detecting atherosclerosis within the aorta.
- Further research into AVC as a marker for cardiovascular risk is warranted.
Abstract:
Aortic valve calcium without stenosis and mitral annulus calcium (MAC) are known to correlate with atherosclerotic risk factors. Recently, it has been reported that MAC is associated with atherosclerosis of the cardiovascular system, suggesting MAC as an atherosclerotic process by itself. Hence, the aim of the present study was to determine whether a similar association between aortic valve calcium and aortic atheroma exists. Ninety-six patients (54 men and 42 women, mean age 72 +/- 12 years) with aortic valve calcium who underwent transesophageal echocardiography (TEE) formed the study group. They were compared with 92 sex- and age-matched patients without aortic valve calcium who underwent TEE for the same indications during the same period. The presence and echocardiographic features of aortic atheromas were evaluated by TEE. No differences were found between the groups in risk factors for atherosclerosis or in indications for referral for TEE. Significantly higher rates were found in the aortic valve calcium group for prevalence of aortic atheroma (86% vs 30%, p = 0.001). This significant trend was also consistent with the dimension and complexity of the atheromas. On multivariate analysis aortic valve calcium, and MAC were the only independent predictors of aortic atheroma (p = 0.0001, 0.006 respectively). We conclude that there is a significant association between the presence of aortic valve calcium and the presence and severity of aortic atheroma. Thus, aortic valve calcium may serve as a window to atherosclerosis of the aorta.