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The association between aortic valve calcification, cardiovascular risk factors, and cardiac size and function in a general population

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Abstract

To determine the presence and extent of aortic valve calcification (AVC) quantified by non-contrast cardiac computed tomography (NCCT), to determine the association between traditional cardiovascular risk factors and AVC score, and to evaluate the association between AVC and cardiac size and function assessed by echocardiography, in a general population aged 65–75 years. A random sample of 2060 individuals were invited to undergo NCCT through which their AVC score was assessed. Individuals with an AVC score ≥ 300 arbitrary units (AU) were invited for a transthoracic echocardiography together with age-matched controls. Descriptive statistics and multiple regression analyses were performed to identify risk factors associated with AVC and to describe associations between AVC score and echocardiographic findings. Of 2060 individuals invited 664 males and 636 females participated. Among those, 455 (68.5%) of males and 358 (56.3%) of females had AVC scores > 0 AU. The median AVC score was 6 AU (IQR 0–3064). Seventy-seven (11.6%) males and 20 (3.1%) females had an AVC score ≥ 300 AU. In a multiple regression analysis, age, sex, prior cardiovascular disease, smoking, and hypertension were associated with AVC score, while diabetes, hypercholesterolemia and kidney function were not. Individuals with AVC ≥ 300 AU had higher peak and mean aortic valve gradient, smaller indexed aortic valve area, greater left ventricular mass, and larger left atrial (LA) volume. In a random population sample of individuals aged 65–75 years, AVC was common and associated with most known cardiovascular risk factors. AVC ≥ 300 AU was associated with concentric remodeling and LA dilatation.

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Acknowledgements

The study was supported by grants from the Center for Individualized Medicine in Arterial disease (CIMA), University of Southern Denmark, and the Region of Southern Denmark. Special thanks go to Dr. MH Fredgart for performing the scans for inter- and intraobserver variability and aiding with the calculations of scores.

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Authors and Affiliations

  1. Department of Cardiology, Odense University Hospital, Sdr. Boulevard 29, 5500, Odense C, Denmark

    Lida Khurrami, Jacob Eifer Møller, Jordi Sanchez Dahl, Rasmus Carter-Storch, Nicolaj Lyhne Christensen & Axel Cosmus Pyndt Diederichsen

  2. Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

    Jacob Eifer Møller

  3. Department of Internal Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, USA

    Manan Pareek

  4. Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark

    Jes Sanddal Lindholt

  5. Elitary Research Centre of Individualised Medicine in Arterial Disease (CIMA), Odense, Denmark

    Jes Sanddal Lindholt & Axel Cosmus Pyndt Diederichsen

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  1. Lida Khurrami
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Correspondence to Lida Khurrami.

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Khurrami, L., Møller, J.E., Dahl, J.S. et al. The association between aortic valve calcification, cardiovascular risk factors, and cardiac size and function in a general population. Int J Cardiovasc Imaging 37, 711–722 (2021). https://doi.org/10.1007/s10554-020-02012-2

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