Aortic valve calcification - Determinants and progression in the population
Aortic valve calcification - Determinants and progression in the population
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DOI：
10.1161/01.atv.0000255952.47980.c2
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发表时间：
2007-03-01
影响因子：
8.7
通讯作者：
Enriquez-Sarano, Maurice
中科院分区：
文献类型：
--
作者：
Messika-Zeitoun, David;Bielak, Lawrence F.;Enriquez-Sarano, Maurice
背景 - 主动脉瓣钙化 (AVC) 被认为是退行性的。最近的数据表明与动脉粥样硬化或冠状动脉疾病 (CAD) 存在关联。方法和结果 - 通过电子束计算机断层扫描对 262 名 60 岁以上人群的研究参与者进行了 AVC 和冠状动脉钙化 (CAC) 前瞻性评估。随着年龄的增长（P < 0.01）和男性（P < 0.05），AVC 很常见（27%）。 AVC 与糖尿病、高血压、较高的体重指数和血糖相关（所有 P < 0.05）。 AVC 是 CAD 患病率较高 (P < 0.01) 和严重程度较高的标志（CAC 评分：441 +/- 802 对比 265 +/- 566，P < 0.05），与年龄无关。随访 3.8 +/- 0.9 年后，AVC 评分增加（94 +/- 271 与 54 +/- 173，P < 0.01，+11 +/- 32 U/年），基线 AVC 评分越高，则增加得越快（P < 0.01）。与未接受 AVC 的参与者相比，从头获得 AVC 与较高的 LDL 胆固醇（141 +/- 31 与 121 +/- 27 mg/dL，P < 0.05）和更快的 CAC 进展相关（+78 +/- 87 与 +28 +/- 47 U/年，P < 0.05）。在多变量分析中，LDL-胆固醇独立决定 AVC 的获得，而较高的基线 AVC 评分决定现有 AVC 的更快进展。结论 - 在人群中，AVC 与衰老和动脉粥样硬化危险因素有关。 AVC 是亚临床 CAD 的标志。 AVC 是进行性的，随着进行性动脉粥样硬化而从头出现，而已建立的 AVC 进展独立于动脉粥样硬化危险因素，并且随着初始 AVC 负荷的增加而进展更快。
Background - Aortic valve calcification (AVC) is considered degenerative. Recent data suggested links to atherosclerosis or coronary disease ( CAD).Methods and Results - AVC and coronary artery calcifications (CAC) were prospectively assessed by Electron-Beam-Computed- Tomography in 262 population-based research participants >= 60 years. AVC was frequent (27%) with aging (P < 0.01) and in men (P < 0.05). AVC was associated with diabetes, hypertension, higher body-mass-index, and serum glucose (all P < 0.05). AVC was a marker of higher prevalence (P < 0.01) and severity of CAD (CAC score: 441 +/- 802 versus 265 +/- 566, P < 0.05) independently of age. After follow-up of 3.8 +/- 0.9 years, AVC score increased (94 +/- 271 versus 54 +/- 173, P < 0.01, +11 +/- 32 U/year), faster with higher baseline AVC score (P < 0.01). Compared with participants remaining free of AVC, de novo acquisition of AVC was associated with higher LDL-cholesterol (141 +/- 31 versus 121 +/- 27 mg/dL, P < 0.05) and faster CAC progression (+78 +/- 87 versus +28 +/- 47 U/year, P < 0.05). In multivariate analysis, LDL-cholesterol independently determined AVC acquisition while higher baseline AVC scores determined faster progression of existing AVC.Conclusion - In the population, AVC is frequent with aging and atherosclerotic risk factors. AVC is a marker of subclinical CAD. AVC is progressive, appearing de novo with progressive atherosclerosis whereas established AVC progresses independently of atherosclerotic risk factors and faster with increasing initial AVC loads.