Association of mitral annular calcification and aortic valve morphology: a substudy of the aortic stenosis progression observation measuring effects of rosuvastatin (ASTRONOMER) study
| Autor: | A. Shekhar Pandey, Peter J. Giannoccaro, Jean G. Dumesnil, Kwan L. Chan, Campbell D. Joyner, John Jue, Isabelle Gaboury, Randall A. Sochowski, Kapil M Bhagirath, Davinder S. Jassal, James W. Tam, Koon K. Teo |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Aortic valve medicine.medical_specialty Adolescent Asymptomatic Internal medicine Mitral valve medicine Humans Mitral Valve Stenosis Multicenter Studies as Topic cardiovascular diseases Aged Randomized Controlled Trials as Topic Aged 80 and over business.industry Calcinosis Aortic Valve Stenosis Middle Aged medicine.disease Stenosis Blood pressure medicine.anatomical_structure Aortic Valve Aortic valve stenosis cardiovascular system Cardiology Mitral Valve Female Radiology medicine.symptom Aortic valve calcification Cardiology and Cardiovascular Medicine business Calcification |
| Zdroj: | European Heart Journal. 29:1542-1547 |
| ISSN: | 1522-9645 0195-668X |
| Popis: | Aims Mitral annular calcification (MAC) is characterized by calcium and lipid deposition in the annular fibrosa of the mitral valve. Although individuals with MAC are at increased risk of cardiovascular events, little is known about the significance of this finding in patients with concurrent aortic stenosis (AS). The aim of this study was to describe the association of baseline MAC and aortic valve morphology in asymptomatic patients enrolled in the ASTRONOMER study, a multicentre study to assess the effect of Rosuvastatin on the progression of AS. Methods and results At baseline, transthoracic echocardiography was performed with two-dimensional and Doppler imaging following a standardized protocol. Echo measurements including left ventricular (LV) dimensions and aortic root dimensions were obtained according to the ASE recommendations. MAC was identified by bright echoes at the base of the mitral leaflets or annulus on 2D imaging, and aortic valve calcification by visualization of bright echoes on the aortic valve leaflets. The degree of calcification was semi-quantitated from absent to severe. The study population included 219 patients (57 ± 14 years; 129 males), divided into two pre-specified categories; bicuspid ( n = 133) and tricuspid ( n = 86) aortic valves. Baseline LV dimensions, aortic valve haemodynamics, and cholesterol profiles were similar between the two groups at baseline. Individuals with tricuspid aortic valves were older, more hypertensive, with higher degrees of MAC and AV calcification ( P < 0.001). The higher degree of MAC persisted in patients with tricuspid AV after adjustment for age and systolic blood pressure ( P = 0.004). Conclusion In patients with asymptomatic mild to moderate AS, MAC is more prevalent in those individuals with tricuspid AV, independent of age, and systolic blood pressure. Whether the degree of MAC may be a surrogate for atherosclerosis, and predict the subset of patients who will respond to statin therapy in preventing the progression of AS, remains to be determined. |
| Databáze: | OpenAIRE |
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