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[Progression of senile aortic valve calcification: echocardiographic and clinical assessment]
1Cardiovascular Institute, Tokyo.
Insights
Senile aortic valve calcification progression is linked to reduced left ventricular outflow tract (LVOT) dimensions, especially in women. Mitral annular calcification also increases with disease severity.
Area of Science:
- Cardiology
- Geriatrics
- Echocardiography
Background:
- Senile aortic valve calcification is a common condition in older adults.
- Understanding the factors influencing its progression is crucial for patient management.
- Echocardiographic assessment plays a key role in evaluating aortic valve disease.
Purpose of the Study:
- To investigate clinical and echocardiographic factors associated with senile aortic valve calcification progression.
- To analyze differences in left ventricular outflow tract (LVOT) dimensions across disease severity groups.
- To explore the relationship between mitral annular calcification and aortic valve calcification severity.
Main Methods:
- Retrospective analysis of clinical and echocardiographic data from patients >69 years with senile aortic valve calcification.
- Patients categorized into three groups based on cusp involvement, pliability, and aortic valve area (AVA).
- Comparison of LVOT dimensions, left ventricular characteristics, and mitral annular calcification frequency between groups.
Main Results:
- Progressive reduction in LVOT dimensions observed with increasing aortic valve calcification severity in both males and females.
- LVOT reduction was not correlated with left ventricular hypertrophy or aortic annulus dimensions.
- Higher prevalence of mitral annular calcification in females with severe aortic valve calcification (group 3).
Conclusions:
- Reduced LVOT dimensions are a significant indicator of senile aortic valve calcification progression.
- Mitral annular calcification is more frequent in advanced stages of aortic valve calcification, particularly in women.
- These findings highlight potential echocardiographic markers for monitoring disease advancement.
Abstract:
Factors involved in the progression of senile aortic valve calcification were evaluated by analyzing the clinical and echocardiographic characteristics of patients older than 69 years with senile aortic valve calcification. The patients were divided into three groups; group 1: 46 male and 40 female patients with calcification of one cusp and almost normal pliability of three cusps, group 2: 48 males and 55 female patients with calcification of two or three cusps, mildly reduced pliability of calcified cusps, and aortic valve area (AVA) > or = 2.0 cm2, group 3: 26 male and 31 female patients with calcification of two or three cusps, significantly reduced pliability of calcified cusps, and AVA < or = 1.5 cm2. There were no significant differences in age, weight, height, left ventricular dimension, or left ventricular wall thickness between these three groups. For male patients, the end-diastolic maximum left ventricular outflow tract dimensions (LVOT) in groups 1, 2, and 3 were 20 +/- 2 mm, 19 +/- 2 mm (p < 0.01 vs group 1), and 17 +/- 3 mm (p < 0.001 vs group 1, p < 0.01 vs group 2), respectively. For female patients, the LVOTs of groups 1, 2, and 3 were 18 +/- 2 mm, 16 +/- 2 mm (p < 0.001 vs group 1), and 16 +/- 2 mm (p < 0.001 vs group 1), respectively. Reduction in LVOT was not associated with left ventricular hypertrophy or decrease in dimension of aortic annulus. In female patients, the frequency of mitral annular calcification of group 3 was 61% [p < 0.05 vs group 1 (35%), p < 0.01 vs group 2 (25%)].(ABSTRACT TRUNCATED AT 250 WORDS)