Factors associated with the progression of aortic valve calcification in older adults

• Published in: International journal of cardiology Vol. 381; pp. 76 - 80
• Main Authors: Leibowitz, David, Yoshida, Yuriko, Jin, Zhezhen, Nakanishi, Koki, Mannina, Carlo, Elkind, Mitchell S.V., Rundek, Tatjana, Homma, Shunichi, Sacco, Ralph L., Di Tullio, Marco R.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.06.2023
• Subjects: Aged; Aged, 80 and over; Aortic Valve - pathology; Aortic valve calcification; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - epidemiology; Biomarkers; Echocardiography; Humans; Transforming Growth Factor beta1; Transforming growth factor β1; Aortic valve calcification; Echocardiography; Transforming growth factor β1
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2023.03.059

Aortic valve calcification (AVC) is a common valvular abnormality that predisposes to stenosis; AVC progression and factors associated with it remain unclear. We investigated the association of clinical factors and serum biomarkers with AVC progression in a population-based cohort of older adults. Participants enrolled in both the Cardiovascular Abnormalities and Brain Lesion study (CABL; years 2005–2010) and the Subclinical Atrial Fibrillation And Risk of Ischemic Stroke study (SAFARIS;2014–2019) represent the study cohort. AVC was defined as bright dense echoes >1 mm in size on ≥1 cusps; each cusp was graded on a scale of 0 (normal) to 3 (severe calcification) at baseline and follow up. Serum biomarkers were measured at the time of follow-up assessment. 373 participants (mean 68.1 ± 7.6 years of age, 146 M/ 227F) were included. 139 (37%) had AVC progression;93 (25%) had mild progression (1 grade), and 46 (12%) had moderate-severe progression (≥2 grades). The only significant clinical predictor of any progression was the use of anti-hypertensive medication which was associated with older age, higher BMI and more frequent hypertension, diabetes and hyperlipidemia. In multivariable analysis including biomarkers, transforming growth factor beta 1 (TGF-β1) was significantly associated with both all and moderate-severe AVC progression. A significant number of elderly subjects with AVC show progression of their valve disease; individual vascular risk factors are not associated with AVC progression, although a combined effect may exist. Higher levels of TGF-β1 are observed in individuals with AVC progression. [Display omitted] •Aortic valve calcification (AVC) is a common progressive valvular abnormality.•We measured AVC in elderly subjects at baseline and after a mean 8 year follow up.•Individual vascular risk factors are not associated with AVC progression.•Higher levels of transforming growth factor beta in subjects with AVC progression.