心血管疾患と診断

Background: Factors associated with rapid progression of aortic valve calcification (AVC) remains insufficiently addressed. The aim of this study was to identify risk factors that predict the progression of AVC and whether there is an association with coronary artery calcification (CAC).

Methods: We retrospectively identified patients with two non-contrast, gated x-ray computed tomography (CT) scans for AVC scoring. Medical records were reviewed, rate of increase in AVC over time was calculated, and a multivariable model was used to determine predictors.

Results: In 360 patients studied, the mean rate of increase in AVC per year was incrementally higher according to baseline AVC. For patients with baseline AVC score <250 AU, the mean AVC rate per year was 15.8±26.8; and for >1000 AU the mean rate was 280.3±284.2 (p-value <0.001). Use of warfarin anticoagulation was found to be significantly associated with a higher rate of AVC score increase (12.0% in patients with baseline AVC <250 Vs 33.3% patients with baseline AVC >1000) (p <0.05). After adjustment for age, factors noted to have an increased rate of AVC include baseline AVC and oral anticoagulant use (both p <0.05).

Discussion: The initial CAC score was higher in patients with higher AVC, but the mean rate of increase in CAC score was not found to be statistically significantly related to AVC. There was no statistically significant association between conventional risk factors or CACS. These data may help determine appropriate follow up intervals and risk stratification of patients with AVC.

Conclusion: The rate of change in AVCS increases according to higher baseline AVC. The rate of calcification is also associated with the use of oral anticoagulants. These data may help determine appropriate follow up intervals and risk stratification of patients with AVCS.