Progression of Aortic Valve Calcification: Association With Coronary Atherosclerosis and Cardiovascular Risk Factors

Abstract

Background Recent studies demonstrated an influence of atherosclerotic risk factors on the progression of aortic valve stenosis. The extent of aortic valve calcification (AVC) was also found to be a strong predictor of stenosis progression. We investigated the influence of the LDL cholesterol level (LDL), other standard cardiovascular risk factors, and the extent of coronary calcification (CC) on the progression of AVC quantified by electron beam tomography (EBT). Methods and Results In 104 patients (64.7±8 years, 89 male) with an EBT scan positive for AVC, CC and AVC were quantified using a volumetric score. EBT was repeated at a mean interval of 15 months (10 to 36 months), and the progression of AVC and CC was determined. Patients were divided into 2 groups according to LDL: group 1, LDL≤3.36 mmol/L (130 mg/dL), 57 patients; group 2, LDL>3.36 mmol/L (130 mg/dL), 47 patients. Mean values for CC were 546±932 mm 3 in scan 1 and 665±1085 mm 3 in scan 2 for AVC 324±796 mm 3 and 404±1076 mm 3 , respectively. The mean progression of CC was 27±37% (group 1, 16±22%; group 2, 39±46%, P ≤0.001) and of AVC was 25±38% (group 1, 9±22%; group 2, 43±44%, P ≤0.001). Conclusions Quantification of AVC by EBT permits new insights into the progression of aortic valve sclerosis. We observed a strong influence of LDL cholesterol level on the progression of AVC and CC, suggesting that lipid-lowering therapy may decrease the progression of aortic valve calcification.