Valvular heart diseaseIncidence and Progression of Aortic Valve Calcium in the Multi-Ethnic Study of Atherosclerosis (MESA)
Section snippets
Methods
MESA was initiated by the National Heart, Lung, and Blood Institute (Bethesda, Maryland) to characterize subclinical cardiovascular disease (CVD) and its progression. A full description of the study design and recruitment process has been previously reported.1 A total of 6,814 free-living people without clinically apparent CVD, aged 45 to 84 years, were recruited from 6 United States communities (Baltimore City and County, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles
Results
Of the 5,880 subjects with follow-up CT examinations, the mean between-scan interval was 2.4 ± 0.9 years. A total of 5,142 subjects (87%) did not have AVC on the baseline CT examination, and 738 (13%) had prevalent AVC, with a median Agatston score of 56 (IQR 19 to 137). As shown in Figure 1, the former group included the population at risk of incident AVC, and the latter group defined the population at risk of AVC progression. The baseline demographic characteristics of this population are
Discussion
The present analysis of the MESA cohort, using quantitative measures of AVC from serial CT imaging, has provided important insights into early-stage AVC in a primary prevention population. Although it is well-known that AVC prevalence increases with age,7 ours is the first to show that the incidence rate of AVC increases with age and that age is independently associated with disease initiation. Thus, AVC is more common with age because of both the accumulation of cases and an increase in the
Acknowledgment
We thank Susan Larsen, BA, for assistance in manuscript preparation and the other investigators, staff, and participants of the MESA study for their valuable contributions. A full list of the participating MESA investigators and institutions can be found at www.mesa-nhlbi.org.
References (25)
- et al.
The relationship between oxidized LDL and other cardiovascular risk factors and subclinical CVD in different ethnic groups: the Multi-Ethnic Study of Atherosclerosis (MESA)
Atherosclerosis
(2007) - et al.
Reproducibility of CT measurements of aortic valve calcification, mitral annulus calcification, and aortic wall calcification in the multi-ethnic study of atherosclerosis
Acad Radiol
(2006) - et al.
Effect of scanner type on the reproducibility of extracoronary measures of calcification: the Multi-Ethnic Study of Atherosclerosis
Acad Radiol
(2007) - et al.
Clinical factors associated with calcific aortic valve diseaseCardiovascular health study
J Am Coll Cardiol
(1997) - et al.
Correlation of serum lipids, calcium, and phosphorus, diabetes mellitus and history of systemic hypertension with presence or absence of calcified or thickened aortic cusps or root in elderly patients
Am J Cardiol
(1987) - et al.
Clinical factors, but not C-reactive protein, predict progression of calcific aortic-valve disease: the cardiovascular health study
J Am Coll Cardiol
(2007) - et al.
Association of coronary risk factors with progression of valvular aortic stenosis in older persons
Am J Cardiol
(2001) - et al.
Progression of valvular aortic stenosis in adults: literature review and clinical implications
Am Heart J
(1996) - et al.
Progression of aortic valve sclerosis to aortic stenosis
Am J Cardiol
(2003) - et al.
Association of cholesterol levels, hydroxymethylglutaryl coenzyme-A reductase inhibitor treatment, and progression of aortic stenosis in the community
J Am Coll Cardiol
(2002)
Factors leading to progression of valvular aortic stenosis
Am J Cardiol
Multi-ethnic study of atherosclerosis: objectives and design
Am J Epidemiol
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This research was supported by grant R01-HL-63963-01A1, and by contracts N01-HC-95159 through N01-HC-95165 and N01-HC-95169 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Dr. Budoff has received honoraria from, and is on, the Speakers' Bureau of GE Healthcare (Bethesda, Maryland). Dr. O'Brien has received honoraria from, and is on, the Speakers' Bureaus of AstraZeneca (Wilmington, Delaware), Bristol-Myers Squibb (New York, New York), and Merck and Co., Inc. (Whitehouse Station, New Jersey).
Drs. Owens, Katz and O'Brien had full access to the data and take responsibility for its integrity. All authors have read and approve the manuscript as submitted.
The National Heart, Lung, and Blood Institute participated in the design and conduct of the MESA study, and the National Heart, Lung, and Blood Institute Project Office reviewed and approved the manuscript before submission.