on December 21, 2006
Published online before print December 21, 2006, doi: 10.1161/01.ATV.0000255952.47980.c2
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Submitted on May 25, 2006
Accepted on November 20, 2006
Aortic Valve Calcification. Determinants and Progression in the Population
David Messika-Zeitoun ;
From the Divisions of Cardiovascular Diseases and Internal Medicine (D.M.-Z., V.T.N., J.M., A.J.T., M.E.-S.), Radiology (P.F.S., J.F.B.), Hypertension (S.T.T.), and Biostatistics (C.S.), Mayo Clinic, Rochester, Minn; and Epidemiology (L.F.B., P.A.P.), University of Michigan, Ann Arbor.
* To whom correspondence should be addressed. E-mail: sarano.maurice{at}mayo.edu.
Background--Aortic valve calcification (AVC) is considered degenerative. Recent data suggested links to atherosclerosis or coronary disease (CAD).
Methods and Results--AVC and coronary artery calcifications (CAC) were prospectively assessed by Electron-Beam-Computed-Tomography in 262 population-based research participants 
60 years. AVC was frequent (27%) with aging (P<0.01) and in men (P<0.05). AVC was associated with diabetes, hypertension, higher body-mass-index, and serum glucose (all P<0.05). AVC was a marker of higher prevalence (P<0.01) and severity of CAD (CAC score: 441±802 versus 265±566, P<0.05) independently of age. After follow-up of 3.8±0.9 years, AVC score increased (94±271 versus 54±173, P<0.01, +11±32 U/year), faster with higher baseline AVC score (P<0.01). Compared with participants remaining free of AVC, de novo acquisition of AVC was associated with higher LDL-cholesterol (141±31 versus 121±27 mg/dL, P<0.05) and faster CAC progression (+78±87 versus +28±47 U/year, P<0.05). In multivariate analysis, LDL-cholesterol independently determined AVC acquisition while higher baseline AVC scores determined faster progression of existing AVC.
Conclusion--In the population, AVC is frequent with aging and atherosclerotic risk factors. AVC is a marker of subclinical CAD. AVC is progressive, appearing de novo with progressive atherosclerosis whereas established AVC progresses independently of atherosclerotic risk factors and faster with increasing initial AVC loads.
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