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The association of incidentally detected heart valve calcification with future cardiovascular events

Martijn J A Gondrie1, Yolanda van der Graaf, Peter C Jacobs

  • 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, PO Box 85500, 3508 GA Utrecht, Netherlands. m.gondrie@umcutrecht.nl

European Radiology
|November 9, 2010
PubMed

Insights

Incidental aortic valve calcification (AVC), mitral valve calcification (MVC), and mitral annular calcification (MAC) detected on routine chest CT scans predict future cardiovascular events and valve disease.

Area of Science:

  • Cardiology
  • Radiology
  • Preventive Medicine

Background:

  • Incidental findings on routine imaging are increasingly recognized.
  • The prognostic significance of heart valve calcification on chest CT is not fully established.
  • Early identification of cardiovascular risk factors is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the prognostic value of incidental aortic valve calcification (AVC), mitral valve calcification (MVC), and mitral annular calcification (MAC) for cardiovascular events.
  • To assess the association of these calcifications with non-rheumatic valve disease.
  • To determine the utility of routine chest CT for identifying subclinical cardiovascular risk.

Main Methods:

  • A case-cohort study design was employed with 10410 patients undergoing chest CT.
  • Follow-up was conducted for a median of 17 months, excluding patients referred for cardiovascular disease.
  • Valve calcification was graded by three reviewers, and Cox-proportional hazard analysis was used to assess prognostic value.

Main Results:

  • Severe AVC, MVC, or MAC were associated with significantly increased risks of cardiovascular events (HRs 2.03, 2.08, 1.53, respectively).
  • The risk for valve-specific endpoints was substantially elevated for severe AVC (HR 14.57), MVC (HR 8.78), and MAC (HR 2.43).
  • 515 cardiovascular events were recorded during the follow-up period.

Conclusions:

  • Incidental heart valve calcification on routine chest CT is an independent predictor of future cardiovascular events.
  • Routine chest CT findings can contribute to clinical care by identifying subclinical disease.
  • This study supports an evidence-based approach to reporting incidental subclinical findings on imaging.
Abstract

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