Clinical significance of calcification of the fibrous skeleton of the heart and aortosclerosis in community dwelling elderly. The Cardiovascular Health Study (CHS)
Clinical significance of calcification of the fibrous skeleton of the heart and aortosclerosis in community dwelling elderly. The Cardiovascular Health Study (CHS)
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DOI：
10.1016/j.ahj.2005.03.052
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发表时间：
2006-01-01
影响因子：
4.8
通讯作者：
Manolio, TA
中科院分区：
文献类型：
--
作者：
Barasch, E;Gottdiener, JS;Manolio, TA
二尖瓣环钙化（MAC）、主动脉瓣环钙化（AAC）和主动脉瓣硬化（AVS）与衰老有关，MAC和AVS是晚期动脉粥样硬化的标志物。没有研究检查的患病率和临床相关性的所有3种形式的钙化在一个单一的自由生活的老年population.Methods我们使用2-climensional超声心动图评估MAC，AAC，AVS和所有3个结合在3929名参与者，平均年龄76 +/- 5岁，60%的妇女，在心血管健康研究，一项旨在评估老年人心血管疾病（CVD）危险因素和结局的前瞻性社区观察性研究。结果1640例（42%）受试者中发现二尖瓣环钙化，1710例（44%）为AAC，2114例（54%）AVS，662例（17%）合并所有3种AVS。有这些发现的参与者比没有这些发现的参与者年龄更大，MAC的参与者比AAC和AVS的参与者有更差的心血管，肾脏，代谢和功能特征。经年龄、性别和种族调整的logistic回归分析发现，3种钙化类别与CVD之间存在显著相关性，最强的是合并充血性心力衰竭组（比值比2.04，95%CI 1.34-3.09）。在高度调整的模型，只有MAC与CVD，和关联的强度相关的严重程度MAC.Conclusions在自由生活的老年人，MAC，AAC和AVS是非常普遍的，并与CVD。特别是二尖瓣环钙化与CVD和不良生物医学特征密切相关。
Background Mitral annular calcification (MAC), aortic annular calcification (AAC), and aortic valve sclerosis (AVS) are associated with aging, and MAC and AVS are markers of advanced atherosclerosis. No studies have examined the prevalence and the clinical relevance of all 3 forms of calcification in a single free-living elderly population.Methods We used 2-climensional echocardiography to evaluate MAC, AAC, AVS and all 3 combined in 3929 participants, mean age 76 +/- 5 years, 60% women, in the Cardiovascular Health Study, a prospective community-based observational study designed to assess cardiovascular disease (CVD) risk factors and outcomes in elderly persons.Results Mitral annular calcification was found in 1640 (42%) subjects, AAC in 1710 (44%), AVS in 2114 (54%), and all 3 combined in 662(17%). The participants with these findings were older than those without them, and those with MAC had worse cardiovascular, renal, metabolic, and functional profile than those with AAC and AVS. Age-, sex-, and race-adjusted logistic regression analysis found a significant association between the 3 calcification categories and CVD, the strongest being between the combined group with congestive heart failure (odds ratio 2.04, 95% CI 1.34-3.09). In highly adjusted models, only MAC was associated with CVD, and the strength of association was related to the severity of MAC.Conclusions In free-living elderly, MAC, AAC, and AVS are highly prevalent and are associated with CVD. Mitral annular calcification in particular has strong association with CVD, and with an adverse biomedical profile.