Related Experiment Video
Updated: Aug 7, 2025
Isolation of Mouse Interstitial Valve Cells to Study the Calcification of the Aortic Valve In Vitro
Published on: May 10, 2021
Aortic Valve Calcium in Relation to Subclinical Cardiac Dysfunction and Risk of Heart Failure
Fang Zhu1, Yannick Kaiser1,2, Eric Boersma3
1Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, The Netherlands (F.Z., Y.K., D.B., M.K.).
Insights
Aortic valve calcium (AVC) is linked to cardiac dysfunction and increases heart failure (HF) risk. Higher AVC levels, particularly above 300, significantly elevate the risk of developing HF.
Area of Science:
- Cardiology
- Medical Imaging
- Public Health
Background:
- The association between mild aortic valve calcium (AVC) and subclinical cardiac dysfunction or heart failure (HF) risk is not well understood.
- This study investigates the link between computed tomography-assessed AVC and cardiac dysfunction, as well as HF incidence in the general population.
Purpose of the Study:
- To determine the association of AVC with echocardiographic measures of cardiac dysfunction.
- To assess the association of AVC with incident heart failure in a general population cohort.
Main Methods:
- Utilized data from 2348 participants in the Rotterdam Study without prior HF history.
- Employed linear regression for AVC and echocardiographic measures, and Fine and Gray subdistribution hazard models for AVC and incident HF, accounting for competing risks.
Main Results:
- AVC presence and higher levels correlated with increased left ventricular mass and left atrial size.
- A log (AVC+1) increase was associated with a 10% rise in HF hazard.
- AVC levels between 300-799 and ≥800 significantly increased HF risk (SHR 2.36 and 2.54, respectively).
Conclusions:
- Aortic valve calcium is associated with left ventricular structural changes, independent of traditional cardiovascular risk factors.
- Elevated AVC, particularly higher levels, indicates an increased risk for heart failure development.
Background:
The link between (mild) aortic valve calcium (AVC) with subclinical cardiac dysfunction and with risk of heart failure (HF) remains unclear. This research aims to determine the association of computed tomography-assessed AVC with echocardiographic measurements of cardiac dysfunction, and with HF in the general population.
Methods:
We included 2348 participants of the Rotterdam Study cohort (mean age 68.5 years, 52% women), who had AVC measurement between 2003 and 2006, and without history of HF at baseline. Linear regression models were used to explore relationship between AVC and echocardiographic measures at baseline. Participants were followed until December 2016. Fine and Gray subdistribution hazard models were used to assess the association of AVC with incident HF, accounting for death as a competing risk.
Results:
The presence of AVC or greater AVC were associated with larger mean left ventricular mass and larger mean left atrial size. In particular, AVC ≥800 showed a strong association (body surface area indexed left ventricular mass, β coefficient: 22.01; left atrium diameter, β coefficient: 0.17). During a median of 9.8 years follow-up, 182 incident HF cases were identified. After accounting for death events and adjusting for cardiovascular risk factors, one-unit larger log (AVC+1) was associated with a 10% increase in the subdistribution hazard of HF (subdistribution hazard ratio, 1.10 [95% CI, 1.03-1.18]), but the presence of AVC was not significantly associated with HF risk in fully adjusted models. Compared with the AVC=0, AVC between 300 and 799 (subdistribution hazard ratio, 2.36 [95% CI, 1.32-4.19]) and AVC ≥800 (subdistribution hazard ratio, 2.54 [95% CI, 1.31-4.90]) were associated with a high risk of HF.
Conclusions:
Presence and high levels of AVC were associated with markers of left ventricular structure, independent of traditional cardiovascular risk factors. Larger computed tomography-assessed AVC is an indicative of increased risk for the development of HF.
Related Concept Videos
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:25Aortic Regurgitation III: Medical Management
01:15Aortic Regurgitation I: Introduction
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...