Coronary artery calcification correlates with the presence and severity of valve calcification

Int J Cardiol. 2013 Oct 15;168(6):5263-6. doi: 10.1016/j.ijcard.2013.08.019. Epub 2013 Aug 15.

Abstract

Aim: To investigate the prevalence of coronary artery calcification (CAC) in symptomatic individuals with CT evidence for left heart valve calcification, aortic valve (AVC), mitral valve (MAC) or both.

Methods: This is a retrospective study of 282 consecutive patients with calcification in either the aortic valve or mitral annulus. Calcium scoring of the coronary artery, aortic and mitral valve was measured using the Agatston score.

Results: AVC was more prevalent than MAC (64% vs. 2.5%, p < 0.001), with 34% having both. Absence of CAC was noted in 12.7% of the study population. AVC + CAC were observed in 53.5%, MAC and CAC in 2.1%, and combined AVC, MAC and CAC in 31.6%. The median CAC score was higher in individuals with combined AVC+MAC, followed by those with AVC and lowest was in the MAC group. The majority (40%) of individuals with AVC had CAC score >400, and only in 16% had CAC = 0. The same pattern was more evident in individuals with AVC + MAC, where 70% had CAC score >400 and only 6% had CAC score of 0. These results were irrespective of gender. There was no correlation between AVC and MAC but there was modest correlation between CAC score and AVC score (r = 0.28, p = 0.0001), MAC (r = 0.36, p = 0.0001) and with combined AVC + MAC (r = 0.5, p = 0.0001). AVC score of 262 had a sensitivity of 78% and specificity of 92% for the prediction of presence of CAC.

Conclusion: The presence and extent of calcification in the aortic valve or/and mitral valves are associated with severe coronary artery calcification.

Keywords: Aortic valve calcification; Coronary artery calcification; Mitral annulus calcification; Valve calcification.

MeSH terms

  • Aged
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / pathology*
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / epidemiology*
  • Aortic Valve Stenosis / pathology
  • Calcinosis / diagnostic imaging
  • Calcinosis / epidemiology*
  • Calcinosis / pathology
  • Cardiac Imaging Techniques
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve Stenosis / diagnostic imaging
  • Mitral Valve Stenosis / epidemiology*
  • Mitral Valve Stenosis / pathology
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index*
  • Sex Distribution
  • Tomography, X-Ray Computed
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / epidemiology*
  • Vascular Calcification / pathology

Supplementary concepts

  • Aortic Valve, Calcification of