Abstract 15601: Increased Left Ventricular Mass Predicts Incident Aortic and Mitral Valve Calcification: The Multi-Ethnic Study of Atherosclerosis
Background: Cardiac valve calcification has been associated with left ventricular hypertrophy, which portends cardiovascular events. We evaluated the relationship between left ventricular mass (LVM; standardized for gender, height, and weight) and valve calcification in the Multi-Ethnic Study of Atherosclerosis (MESA).
Methods: MESA is a longitudinal cohort study of men and women aged 45–84 years without evidence of clinical cardiovascular disease. Cardiac magnetic resonance and computed tomography imaging was performed in 5,042 subjects. The relationships of baseline LVM to the prevalence, severity, and incidence of aortic valve calcification (AVC) and mitral annulus calcification (MAC) were determined by regression modeling.
Results: AVC was prevalent in 630 and MAC in 442 subjects (median score 55.9 and 71.1 Agatston units, respectively). During follow-up (mean 2.4±0.9 years), 153 subjects developed incident AVC and 198 incident MAC. After adjustment for age, gender, body mass index, ethnicity, socioeconomic status, physical activity, diabetes, hypercholesterolemia, hypertension, smoking, kidney function, serum lipids, blood pressure, and use of antihypertensive agents and statins, LVM was associated with prevalent AVC (odds ratio=1.09 [95%CI 1.04, 1.15] per 10% increase in %LVM; p=0.0004) and MAC (OR=1.09 [95%CI 1.03, 1.16]; p=0.002) and with calcification severity. LVM was also associated with incident AVC (OR=1.10 [95%CI 1.00, 1.21]; p=0.04) and MAC (OR=1.09 [95%CI 1.00, 1.19]; p=0.05) despite further adjustment for inflammation and subclinical atherosclerosis.
Conclusion: In the large MESA cohort, an association between baseline LVM and incident valve calcification suggests that increased LVM may identify those subjects at high risk for developing AVC and MAC. Further study is needed to determine the mechanisms responsible for this novel association and its impact on patient outcomes.
- Valvular heart disease
- Ventricular remodeling
- Computed tomography
- Magnetic resonance imaging
- © 2010 by American Heart Association, Inc.