Abstract 17935: Serum Parathyroid Hormone is Associated with Valvular Calcification but not with Aortic Root or Coronary Artery Calcification in Aortic Valve Stenosis
Introduction: Several studies have suggested that key regulators of bone metabolism could be involved in pathophysiological pathways of aortic valve stenosis (AS). A recent study reported an association between increased parathyroid hormone (PTH) serum level and faster hemodynamic progression of AS.
Hypothesis: The objective of this study was to assess the association between serum PTH levels and: aortic valve calcification (AVC), aorta root calcification (ARC), and coronary artery calcification (CAC) in patients with AS.
Methods: Serum PTH levels were drawn in 144 patients with AS, prospectively recruited in the PROGRESSA study. Patients underwent a comprehensive Doppler echocardiography and a multidetector computed tomography (MDCT) within one month. AVC, ARC, and CAC were measured by MDCT.
Results: The mean age was 67±12 years (75% male). Median serum PTH was 40.7 ng/L (IQR: 30.4 - 52.5 ng/L). Average peak aortic jet velocity (Vpeak) was 2.9±0.5 m/s and median AVC was 803 AU [IQR: 414 - 1377 AU]. There was a significant correlation between serum PTH levels and AVC (r = 0.18, p=0.03) but not with ARC (r = 0.05, p=0.48) or CAC (r = -0.13, p=0.10). After multivariate analysis adjusted for age, sex, Vpeak, hypertension and creatinine level, serum PTH levels remained independently associated with AVC (p=0.03).
Conclusions: In patients with AS, increased serum levels of PTH are associated with higher AVC but not with ARC or CAC. These findings suggest that pathophysiological processes leading to ectopic calcification may be different in the aortic valve versus in the aorta or coronary arteries. Hyperparathyroidism may contribute to the mineralization of the aortic valve and could represent an interesting target of therapy in AS.
Author Disclosures: L.L. Tastet: None. R. Capoulade: None. E. Larose: None. M. Shen: None. M. Clavel: None. A. Dahou: None. M. Arsenault: None. E. Bédard: None. J.G. Dumesnil: None. P. Mathieu: None. P. Pibarot: None.
- © 2014 by American Heart Association, Inc.