Published Online
on February 6, 2006

A more recent version of this article appeared on February 14, 2006

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Submitted on March 29, 2005
Revised on November 28, 2005
Accepted on November 30, 2005

Mitral and Aortic Annular Calcification Are Highly Associated With Systemic Calcified Atherosclerosis

Matthew A. Allison MD, MPH^*, Philip Cheung BS, Michael H. Criqui MD, MPH, Robert D. Langer MD, MPH, and C. Michael Wright MD

From the Department of Family and Preventive Medicine (M.A.A., M.H.C., R.D.L.), Department of Medicine (M.A.A., M.H.C., C.M.W.), and Department of Bioengineering (P.C.), University of California San Diego, San Diego, Calif.

^* To whom correspondence should be addressed. E-mail: mallison{at}ucsd.edu.

Background--Atherosclerosis has been implicated as a cause of valvular calcification. The aim of this study was to determine whether atherosclerotic calcification in multiple vascular areas is significantly associated with aortic or mitral annular calcification independent of traditional risk factors.

Methods and Results--A total of 1242 consecutive asymptomatic patients free of clinical coronary heart disease were studied by electron-beam computed tomography for the extent of calcium due to atherosclerosis in 5 distinct vascular beds and calcium in the aortic and mitral annuli. Nearly 24% had calcium in the aortic annulus, whereas 8% were found to have mitral annular calcification. Age and a history of hypertension were the only traditional cardiovascular risk factors that were independently associated with prevalent calcification in the aortic and mitral annuli. After adjustment for age, gender, and cardiovascular disease risk factors, subjects with calcium in the thoracic aorta had the highest odds for the presence of aortic annular calcium (OR=3.9, P<0.01), whereas those with calcium in the abdominal aorta had the highest odds for mitral annular calcification (OR=5.1, P=0.01). Standardized increases in calcium in the abdominal aorta (OR=2.0, P<0.01) and iliacs (OR=1.8, P=0.01) were significantly associated with calcium in the aortic annulus after adjustment for the extent of calcium in the other vascular beds, whereas the thoracic aorta was significantly associated (OR=1.4, P=0.02) with calcium in the mitral annulus.

Conclusions--This study supports the hypothesis that calcification of the mitral and aortic annuli is related to atherosclerosis in other vascular beds.

Key words: atherosclerosis • calcium • mitral valve • aorta • valves

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