Prevalence of Aortic Valve Calcium and the Long-Term Risk of Incident Severe Aortic Stenosis.
Prevalence of Aortic Valve Calcium and the Long-Term Risk of Incident Severe Aortic Stenosis.
复制标题
主动脉瓣钙化的患病率和严重主动脉瓣狭窄事件的长期风险。
DOI：
10.1016/j.jcmg.2023.02.018
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Thanas
中科院分区：
文献类型：
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作者：
Whelton,SeamusP;Jha,Kunal;Dardari,Zeina;Razavi,AlexanderC;Boakye,Ellen;Dzaye,Omar;Verghese,Dhiran;Shah,Sanjiv;Budoff,MatthewJ;Matsushita,Kunihiro;Carr,JJeffery;Vasan,RamachandranS;Blumenthal,RogerS;Anchouche,Khalil;Thanas
背景主动脉瓣钙化 (AVC) 是主动脉瓣狭窄 (AS) 的主要机制。目的本研究旨在确定 AVC 的患病率及其与严重 AS 长期风险的关系。方法在 MESA（动脉粥样硬化多种族研究）访视 1 时，对 6,814 名无已知心血管疾病的参与者进行非对比心脏计算机断层扫描。使用 Agatston 方法对 AVC 进行量化，并且得出了标准的年龄、性别和种族/民族特定的 AVC 百分位数。严重 AS 的判定是通过所有医院就诊的图表审查进行的，并辅以第 6 次就诊的超声心动图数据。使用多变量 Cox HR 评估 AVC 与长期严重 AS 之间的关联。结果 913 名参与者 (13.4%) 存在 AVC。 AVC > 0 的概率和 AVC 评分随着年龄的增长而增加，并且在男性和白人参与者中通常最高。一般来说，女性 AVC > 0 的概率与年轻大约 10 岁的同一种族/族裔男性相当。在中位随访 16.7 年中，84 名参与者发生了严重 AS 事件。较高的 AVC 评分与严重 AS 的绝对风险和相对风险呈指数相关，AVC 1 至 99 组、100 至 299 组和与 AVC = 0 相比，≥300。结论 AVC >0 的概率因年龄、性别和种族/民族而有显着差异。 AVC 评分越高，严重 AS 的风险呈指数级增加，而 AVC = 0 则与严重 AS 的长期风险极低相关。 AVC 的测量提供了临床相关信息，以评估个体患严重 AS 的长期风险。
BackgroundAortic valve calcification (AVC) is a principal mechanism underlying aortic stenosis (AS).ObjectivesThis study sought to determine the prevalence of AVC and its association with the long-term risk for severe AS.MethodsNoncontrast cardiac computed tomography was performed among 6,814 participants free of known cardiovascular disease at MESA (Multi-Ethnic Study of Atherosclerosis) visit 1. AVC was quantified using the Agatston method, and normative age-, sex-, and race/ethnicity-specific AVC percentiles were derived. The adjudication of severe AS was performed via chart review of all hospital visits and supplemented with visit 6 echocardiographic data. The association between AVC and long-term incident severe AS was evaluated using multivariable Cox HRs.ResultsAVC was present in 913 participants (13.4%). The probability of AVC >0 and AVC scores increased with age and were generally highest among men and White participants. In general, the probability of AVC >0 among women was equivalent to men of the same race/ethnicity who were approximately 10 years younger. Incident adjudicated severe AS occurred in 84 participants over a median follow-up of 16.7 years. Higher AVC scores were exponentially associated with the absolute risk and relative risk of severe AS with adjusted HRs of 12.9 (95% CI: 5.6-29.7), 76.4 (95% CI: 34.3-170.2), and 380.9 (95% CI: 169.7-855.0) for AVC groups 1 to 99, 100 to 299, and ≥300 compared with AVC = 0.ConclusionsThe probability of AVC >0 varied significantly by age, sex, and race/ethnicity. The risk of severe AS was exponentially higher with higher AVC scores, whereas AVC = 0 was associated with an extremely low long-term risk of severe AS. The measurement of AVC provides clinically relevant information to assess an individual’s long-term risk for severe AS.