Objective: Aortic valve calcification (AVC) appears to have high incidence of cardiovascular risk factors and can be considered as a manifestation of atherosclerosis. Association between low bone mineral density (BMD) and increased prevalence of aortic calcification has been shown in older women mainly in population based studies. However, some studies have reported lack of association between BMD and aortic calcification. Accordingly we aimed to assess AVC in patients undergoing coronary angiography and to compare cardiovascular risk factors and BMD of patients with and without AVC.
Materials and Methods: Study population consisted of 585 consecutive patients (372 male, 213 female mean age 59?10) who underwent coronary angiography. Complete transthoracic echocardiography studies were performed in all patients. AVC was defined as bright dense echos of >1 mm size on one or more cusps and decreased mobility of the involved cusp. All patients were referred to Nuclear Medicine department to measure bone mineral density (T score) using the dual energy x-ray absorptiometry method (DEXA). Age, sex, body mass index, hypertension, diabetes mellitus, coronary artery disease, hypercholesterolemia, and smoking status were recorded in all patients.
Results: The prevalence of AVC in our study population was found to be 27% (160/585). There were not statistically significant differences between two groups in respect to diabetes mellitus, hypercholesterolemia, smoking status (p>0.05 for all). Age and hypertension were found to be independent positive risk factors for AVC, where as body mass index was found to be negatively and independently associated with AVC. Presence of coronary artery disease was significantly higher in patients with AVC compared to those without AVC however it was not found to be associated with AVC. Neither T score nor age- and gender adjusted T score were found to be associated with AVC.
Conclusion: We have demonstrated that age, hypertension, and body mass index are independently associated with AVC. Age-gender adjusted T score measuring BMD is found to be independent of AVC. Although we have shown absence of association between coronary artery disease and AVC, this issue remains to be clarified in further clinical studies.
Key Words: Aortic valve calcification, Bone mineral density, Cardiovascular risk factors, Coronary artery disease, Atherosclerosis, Osteoporosis, T score
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