Aortic valve calcification among elderly males from the general population, associated echocardiographic findings, and clinical implications

Author:

Khurrami Lida1,Møller Jacob Eifer12,Lindholt Jes Sanddal3,Dahl Jordi Sancez1,Fredgart Maise Hoeigaard1,Obel Lasse M3,Steffensen Flemming Hald4,Urbonaviciene Grazina5,Lambrechtsen Jess6,Diederichsen Axel Cosmus Pyndt1ORCID

Affiliation:

1. Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark

2. Department of Cardiology, Copenhagen University Hospital, Blegdamsvej 9, 2100 København, Denmark

3. Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark

4. Department of Cardiology, Sygehus Lillebaelt, Beriderbakken 4, 7100 Vejle, Denmark

5. Department of Cardiology, Regional Hospital Central Jutland, Falkevej 1A, 8600 Silkeborg, Denmark

6. Department of Cardiology, Odense University Hospital, Baagøes Alle 31, 5700 Svendborg, Denmark

Abstract

Abstract Aims Aortic valve calcification (AVC) detected by non-contrast computed tomography (NCCT) associates with morbidity and mortality in patients with aortic valve stenosis. However, the importance of AVC in the general population is sparsely evaluated. We intend to describe the associations between AVC score on NCCT and echocardiographic findings as left atrial (LA) dilatation, left ventricular (LV) hypertrophy, aortic valve area (AVA), peak velocity, mean gradient, and aortic valve replacement (AVR) in a population with AVC scores ≥300 AU. Methods and results Of 10 471 males aged 65–74 years from the Danish Cardiovascular Screening trial (DANCAVAS), participants with AVC score ≥300 AU were invited for transthoracic echocardiography and 828 (77%) of 1075 accepted the invitation. AVC scores were categorized (300–599, 600–799, 800–1199, and ≥1200 AU). AVR was obtained from registries. AVC was significantly associated with a steady increase in LA dilation (10.5%, 16.3%, 15.8%, 19.6%, P = 0.031), LV hypertrophy (3.9%, 6.6%, 8.9%, 10.1%, P = 0.021), peak velocity (1.7, 1.9, 2.1, 2.8 m/s, P = 0001), mean gradient (6, 8, 11, 19 mmHg, P = 0.0001), and a decrease in AVA (2.0, 1.9, 1.7, 1.3 cm2, P = 0.0001). The area under the curve was 0.79, 0.93, and 0.92 for AVA ≤1.5 cm2, peak velocity ≥3.0 m/s, and mean gradient ≥20 mmHg, respectively, and the associated optimal AVC score thresholds were 734, 1081, and 1019 AU. AVC > 1200 AU was associated with AVR (P < 0.0001). Conclusion Among males from the background population, increasing AVC scores were associated with LA dilatation, LV hypertrophy, AVA, peak aortic velocity, mean aortic gradient, and AVR.

Funder

University of Southern Denmark

Region of Southern Denmark

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,General Medicine

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