Pohle Karsten, Otte Merle, Mäffert Ralph, Ropers Dieter, Schmid Michael, Daniel Werner G, Achenbach Stephan
Department of Internal Medicine II, University of Erlangen, Erlangen, Germany.
Mayo Clin Proc. 2004 Oct;79(10):1242-6. doi: 10.4065/79.10.1242.
To analyze the association among aortic valve calcification, cardiovascular risk factors, and coronary artery calcification using electron beam computed tomography (EBCT).
We analyzed cardiac EBCT data obtained for coronary calcium detection in 1000 consecutively enrolled patients (mean +/- SD age, 57.1 +/- 10 years; 69% men) between January 1, 1998, and July 23, 2001. In all patients, atherosclerotic risk factors (hyperlipidemia, hypertension, diabetes, smoking, and family history of coronary artery disease) were documented. With EBCT, the amount of coronary calcification was determined using the Agatston score, and the amount of aortic valve calcification was measured using a volumetric score.
Aortic valve calcification was detected in 177 (17.7%) of the total patient group and was found more frequently in patients with coronary calcification (20.5% in patients with coronary calcium vs 3.8% in patients without coronary calcium; P < .001), hyperlipidemia (19.5% vs 6.5%; P < .001), hypertension (21.7% vs 13.9%; P = .01), or diabetes (30.7% vs 16.6%; P = .002). The volume of aortic valve calcification was significantly higher in patients with vs without hyperlipidemia (P < .001), hypertension (P = .002), and diabetes (P = .001). In a multivariable logistic regression analysis, adjusted for age and sex, hyperlipidemia (P = .001) and the presence of coronary calcification (P < .001) were significant predictors of aortic valve calcification.
A significant association exists among atherosclerotic risk factors, coronary calcification, and the presence and amount of aortic valve calcification.
使用电子束计算机断层扫描(EBCT)分析主动脉瓣钙化、心血管危险因素和冠状动脉钙化之间的关联。
我们分析了1998年1月1日至2001年7月23日期间连续纳入的1000例患者(平均年龄±标准差,57.1±10岁;69%为男性)的心脏EBCT数据,这些数据用于检测冠状动脉钙化。在所有患者中,记录了动脉粥样硬化危险因素(高脂血症、高血压、糖尿病、吸烟和冠状动脉疾病家族史)。使用EBCT,通过阿加斯顿积分确定冠状动脉钙化量,使用容积积分测量主动脉瓣钙化量。
在全部患者组中,177例(17.7%)检测到主动脉瓣钙化,在冠状动脉钙化患者中更常见(有冠状动脉钙化的患者中为20.5%,无冠状动脉钙化的患者中为3.8%;P<.001),高脂血症患者(19.5%对6.5%;P<.001)、高血压患者(21.7%对13.9%;P=.01)或糖尿病患者(30.7%对16.6%;P=.002)中也更常见。有高脂血症、高血压和糖尿病的患者与无这些疾病的患者相比,主动脉瓣钙化体积显著更高(P<.001、P=.002和P=.001)。在多变量逻辑回归分析中,校正年龄和性别后,高脂血症(P=.001)和冠状动脉钙化的存在(P<.001)是主动脉瓣钙化的显著预测因素。
动脉粥样硬化危险因素、冠状动脉钙化以及主动脉瓣钙化的存在和程度之间存在显著关联。