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The Relationship Between Bone Mineral Density and Aortic Valve- Mitral Valve Calcification in Postmenopausal Women

Yıl 2024, Cilt: 7 Sayı: 3, 67 - 73, 03.01.2025
https://doi.org/10.33713/egetbd.1593729

Öz

Objective: Osteoporosis and heart valve calcification (HVC) are common diseases that cause serious morbidity and mortality in the aging population. Our study was planned to investigate the relationship between osteoporosis and HVC in postmenopausal women.
Methods: Postmenopausal patients aged 50-75 years who had bone mineral density (BMD) and echocardiography (ECO) within the last year were included in the study, and lumbar spine (LS) and femoral neck (FN) BMD measurements and ECO measurements were evaluated. BMD measurements were grouped as normal, osteopenia, and osteoporosis. Patients with and without HVC were compared according to the presence of osteopenia and osteoporosis.
Results: A total of 77 postmenopausal women were included in the study. HVC was detected in 38 (49.4%) of them. Only aortic valve calcification (AVC) was detected in 33 patients, only mitral valve calcification (MVC) was detected in 20 patients, and both AVC and MVC were detected in 15 patients. Of the 33 patients with AVC, 25 had LS osteopenia/osteoporosis (OO) and 24 had FN OO. Of the 20 patients with MVC, 15 had LS OO and 15 had FN OO. In conclusion, we found that low bone mass has an independent and negative effect on HVC in postmenopausal women. We speculated that there may be a common pathophysiological mechanism for low BMD and HVC. Conlusion: We concluded that postmenopausal women with osteopenia or osteoporosis should be warned and referred for early diagnosis of HVC.

Kaynakça

  • Massera D, Xu S, Bartz TM, Bortnick AE, Ix JH, Chonchol M, et al. Relationship of bone mineral density with valvular and annular calcification in community-dwelling older people: The Cardiovascular Health Study. Archives of osteoporosis. 2017;12:1-12.
  • Kanis J, Glüer C. for the Committee of Scientific Advisors, International Osteoporosis Foundation. An update on the diagnosis and assessment of osteoporosis with densitometry. Osteoporos Int. 2000;11(3):192-202.
  • Rachner TD, Khosla S, Hofbauer LC. Osteoporosis: now and the future. The Lancet. 2011;377(9773):1276-87.
  • Uchimuro T, Fukui T, Shimizu A, Takanashi S. Mitral valve surgery in patients with severe mitral annular calcification. The Annals of Thoracic Surgery. 2016;101(3):889-95.
  • Mohler III ER, Gannon F, Reynolds C, Zimmerman R, Keane MG, Kaplan FS. Bone formation and inflammation in cardiac valves. Circulation. 2001;103(11):1522-8.
  • Arounlangsy P, Sawabe M, Izumiyama N, Koike M. Histopathogenesis of early-stage mitral annular calcification. Journal of medical and dental sciences. 2004;51(1):35-44.
  • Rajamannan NM, Evans FJ, Aikawa E, Grande-Allen KJ, Demer LL, Heistad DD, et al. Calcific aortic valve disease: not simply a degenerative process a review and agenda for research from the National Heart and Lung and Blood Institute Aortic Stenosis Working Group. Circulation. 2011;124(16):1783.
  • Labovitz AJ, Nelson JG, Windhorst DM, Kennedy HL, Williams GA. Frequency of mitral valve dysfunction from mitral anular calcium as detected by Doppler echocardiography. The American journal of cardiology. 1985;55(1):133-7.
  • Sud K, Agarwal S, Parashar A, Raza MQ, Patel K, Min D, et al. Degenerative mitral stenosis: unmet need for percutaneous interventions. Circulation. 2016;133(16):1594-604.
  • Lindman BR, Clavel M-A, Mathieu P, Iung B, Lancellotti P, Otto CM, et al. Calcific aortic stenosis. Nature reviews Disease primers. 2016;2(1):1-28.
  • Gomel MA, Lee R, Grande-Allen KJ. Comparing the role of mechanical forces in vascular and valvular calcification progression. Frontiers in cardiovascular medicine. 2019;5:197.
  • Chan JJ, Cupples LA, Kiel DP, O'Donnell CJ, Hoffmann U, Samelson EJ. QCT volumetric bone mineral density and vascular and valvular calcification: the Framingham Study. Journal of Bone and Mineral Research. 2015;30(10):1767-74. Rajamannan NM, Subramaniam M, Rickard D, Stock SR, Donovan J, Springett M, et al. Human aortic valve calcification is associated with an osteoblast phenotype. Circulation. 2003;107(17):2181-4.
  • Hyder JA, Allison MA, Wong N, Papa A, Lang TF, Sirlin C, et al. Association of coronary artery and aortic calcium with lumbar bone density: the MESA Abdominal Aortic Calcium Study. American journal of epidemiology. 2009;169(2):186-94.
  • Sugihara N, Matsuzaki M. The influence of severe bone loss on mitral annular calcification in postmenopausal osteoporosis of elderly Japanese women. Japanese circulation journal. 1993;57(1):14-26.
  • Davutoglu V, Yilmaz M, Soydinc S, Celen Z, Turkmen S, Sezen Y, et al. Mitral annular calcification is associated with osteoporosis in women. American Heart Journal. 2004;147(6):1113-6.
  • Aksoy Y, Yagmur C, Tekin GO, Yagmur J, Topal E, Kekilli E, et al. Aortic valve calcification: association with bone mineral density and cardiovascular risk factors. Coronary artery disease. 2005;16(6):379-83.
  • Choi HS, Rhee Y, Hur NW, Chung N, Lee EJ, Lim SK. Association between low bone mass and aortic valve sclerosis in Koreans. Clinical endocrinology. 2009;71(6):792-7.
  • Tankó LB, Christiansen C, Cox DA, Geiger MJ, McNabb MA, Cummings SR. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. Journal of Bone and Mineral Research. 2005;20(11):1912-20.
  • Schulz E, Arfai K, Liu X, Sayre J, Gilsanz V. Aortic calcification and the risk of osteoporosis and fractures. The Journal of Clinical Endocrinology & Metabolism. 2004;89(9):4246-53.
  • Naves M, Rodríguez-García M, Díaz-López JB, Gómez-Alonso C, Cannata-Andía JB. Progression of vascular calcifications is associated with greater bone loss and increased bone fractures. Osteoporosis International. 2008;19:1161-6.
  • Organization WH. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group [meeting held in Rome from 22 to 25 June 1992]: World Health Organization; 1994.
  • Armstrong WF, Ryan T. Feigenbaum's echocardiography: Lippincott Williams & Wilkins; 2012.
  • Abramowitz Y, Jilaihawi H, Chakravarty T, Mack MJ, Makkar RR. Mitral annulus calcification. Journal of the American College of Cardiology. 2015;66(17):1934-41.
  • Coffey S, Cox B, Williams MJ. The prevalence, incidence, progression, and risks of aortic valve sclerosis: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2014;63(25 Part A):2852-61.
  • Nam H-S, Shin M-H, Kweon S-S, Park K-S, Sohn S-J, Rhee J-A, et al. Association of estrogen receptor-α gene polymorphisms with bone mineral density in postmenopausal Korean women. Journal of bone and mineral metabolism. 2005;23:84-9.
  • Uçar M, Demir H. The Relationship of Brain Natriuretic Peptide Level with Biochemical Markers, Bone Mineral Density and Progenitor Factors in Rats with Experimental Osteoporosis. Journal of Anatolian Medical Research. 2022;7(1):5-12.
  • Carrai P, Camarri S, Pondrelli CR, Gonnelli S, Caffarelli C. Calcification of cardiac valves in metabolic bone disease: an updated review of clinical studies. Clinical Interventions in Aging. 2020:1085-95.
  • Arici A, Sozen I. Expression, menstrual cycle-dependent activation, and bimodal mitogenic effect of transforming growth factor-β1 in human myometrium and leiomyoma. American journal of obstetrics and gynecology. 2003;188(1):76-83.
  • Di Minno A, Zanobini M, Myasoedova VA, Valerio V, Songia P, Saccocci M, et al. Could circulating fetuin A be a biomarker of aortic valve stenosis? International journal of cardiology. 2017;249:426-30.
  • Carracedo M, Bäck M. Fetuin A in aortic stenosis and valve calcification: not crystal clear. International journal of cardiology. 2018;265:77-8.
  • Aylin S, Uslu T. The relationship between fetuin-A and bone mineral density in postmenopausal osteoporosis. Archives of Rheumatology. 2013;28(3):195-201.
  • Massera D, Trivieri MG, Andrews JP, Sartori S, Abgral R, Chapman AR, et al. Disease activity in mitral annular calcification: a multimodality study. Circulation: Cardiovascular Imaging. 2019;12(2):e008513.
  • von Mühlen DG, Greendale GA, Garland CF, Wan L, Barrett- Connor E. Vitamin D, parathyroid hormone levels and bone mineral density in community-dwelling older women: the Rancho Bernardo Study. Osteoporosis International. 2005;16:1721-6.
  • Lee T-L, Lee M-H, Chen Y-C, Lee Y-C, Lai T-C, Lin HY-H, et al. Vitamin D attenuates ischemia/reperfusion-induced cardiac injury by reducing mitochondrial fission and mitophagy. Frontiers in Pharmacology. 2020;11:604700.
  • Verdoia M, Pergolini P, Rolla R, Nardin M, Schaffer A, Barbieri L, et al. Impact of high-dose statins on vitamin D levels and platelet function in patients with coronary artery disease. Thrombosis Research. 2017;150:90-5.
  • Christodoulidis G, Vittorio TJ, Fudim M, Lerakis S, Kosmas CE. Inflammation in coronary artery disease. Cardiology in review. 2014;22(6):279-88.
  • Chitalia N, Ismail T, Tooth L, Boa F, Hampson G, Goldsmith D, et al. Impact of vitamin D supplementation on arterial vasomotion, stiffness and endothelial biomarkers in chronic kidney disease patients. PloS one. 2014;9(3):e91363.

The Relationship Between Bone Mineral Density and Aortic Valve- Mitral Valve Calcification in Postmenopausal Women

Yıl 2024, Cilt: 7 Sayı: 3, 67 - 73, 03.01.2025
https://doi.org/10.33713/egetbd.1593729

Öz

Objective: Osteoporosis and heart valve calcification (HVC) are common diseases that cause serious morbidity and mortality in the aging population. Our study was planned to investigate the relationship between osteoporosis and HVC in postmenopausal women.
Methods: Postmenopausal patients aged 50-75 years who had bone mineral density (BMD) and echocardiography (ECO) within the last year were included in the study and lumbar spine (LS) and femoral neck (FN) BMD measurements and ECO measurements were evaluated. BMD measurements were grouped as normal, osteopenia and osteoporosis. Patients with and without HVC were compared according to the presence of osteopenia and osteoporosis.
Results: A total of 77 postmenopausal women were included in the study. HVC was detected in 38 (49.4%) of them. Only aortic valve calcification (AVC) was detected in 33 patients, only mitral valve calcification (MVC) was detected in 20 patients and both AVC and MVC were detected in 15 patients. Of the 33 patients with AVC, 25 had LS osteopenia/osteoporosis (OO) and 24 had FN OO. Of the 20 patients with MVC, 15 had LS OO and 15 had FN OO. In conclusion, we found that low bone mass has an independent and negative effect on HVC in postmenopausal women. We speculated that there may be a common pathophysiological mechanism for low BMD and HVC. Conlusion: We concluded that postmenopausal women with osteopenia or osteoporosis should be warned and referred for early diagnosis of HVC.

Kaynakça

  • Massera D, Xu S, Bartz TM, Bortnick AE, Ix JH, Chonchol M, et al. Relationship of bone mineral density with valvular and annular calcification in community-dwelling older people: The Cardiovascular Health Study. Archives of osteoporosis. 2017;12:1-12.
  • Kanis J, Glüer C. for the Committee of Scientific Advisors, International Osteoporosis Foundation. An update on the diagnosis and assessment of osteoporosis with densitometry. Osteoporos Int. 2000;11(3):192-202.
  • Rachner TD, Khosla S, Hofbauer LC. Osteoporosis: now and the future. The Lancet. 2011;377(9773):1276-87.
  • Uchimuro T, Fukui T, Shimizu A, Takanashi S. Mitral valve surgery in patients with severe mitral annular calcification. The Annals of Thoracic Surgery. 2016;101(3):889-95.
  • Mohler III ER, Gannon F, Reynolds C, Zimmerman R, Keane MG, Kaplan FS. Bone formation and inflammation in cardiac valves. Circulation. 2001;103(11):1522-8.
  • Arounlangsy P, Sawabe M, Izumiyama N, Koike M. Histopathogenesis of early-stage mitral annular calcification. Journal of medical and dental sciences. 2004;51(1):35-44.
  • Rajamannan NM, Evans FJ, Aikawa E, Grande-Allen KJ, Demer LL, Heistad DD, et al. Calcific aortic valve disease: not simply a degenerative process a review and agenda for research from the National Heart and Lung and Blood Institute Aortic Stenosis Working Group. Circulation. 2011;124(16):1783.
  • Labovitz AJ, Nelson JG, Windhorst DM, Kennedy HL, Williams GA. Frequency of mitral valve dysfunction from mitral anular calcium as detected by Doppler echocardiography. The American journal of cardiology. 1985;55(1):133-7.
  • Sud K, Agarwal S, Parashar A, Raza MQ, Patel K, Min D, et al. Degenerative mitral stenosis: unmet need for percutaneous interventions. Circulation. 2016;133(16):1594-604.
  • Lindman BR, Clavel M-A, Mathieu P, Iung B, Lancellotti P, Otto CM, et al. Calcific aortic stenosis. Nature reviews Disease primers. 2016;2(1):1-28.
  • Gomel MA, Lee R, Grande-Allen KJ. Comparing the role of mechanical forces in vascular and valvular calcification progression. Frontiers in cardiovascular medicine. 2019;5:197.
  • Chan JJ, Cupples LA, Kiel DP, O'Donnell CJ, Hoffmann U, Samelson EJ. QCT volumetric bone mineral density and vascular and valvular calcification: the Framingham Study. Journal of Bone and Mineral Research. 2015;30(10):1767-74. Rajamannan NM, Subramaniam M, Rickard D, Stock SR, Donovan J, Springett M, et al. Human aortic valve calcification is associated with an osteoblast phenotype. Circulation. 2003;107(17):2181-4.
  • Hyder JA, Allison MA, Wong N, Papa A, Lang TF, Sirlin C, et al. Association of coronary artery and aortic calcium with lumbar bone density: the MESA Abdominal Aortic Calcium Study. American journal of epidemiology. 2009;169(2):186-94.
  • Sugihara N, Matsuzaki M. The influence of severe bone loss on mitral annular calcification in postmenopausal osteoporosis of elderly Japanese women. Japanese circulation journal. 1993;57(1):14-26.
  • Davutoglu V, Yilmaz M, Soydinc S, Celen Z, Turkmen S, Sezen Y, et al. Mitral annular calcification is associated with osteoporosis in women. American Heart Journal. 2004;147(6):1113-6.
  • Aksoy Y, Yagmur C, Tekin GO, Yagmur J, Topal E, Kekilli E, et al. Aortic valve calcification: association with bone mineral density and cardiovascular risk factors. Coronary artery disease. 2005;16(6):379-83.
  • Choi HS, Rhee Y, Hur NW, Chung N, Lee EJ, Lim SK. Association between low bone mass and aortic valve sclerosis in Koreans. Clinical endocrinology. 2009;71(6):792-7.
  • Tankó LB, Christiansen C, Cox DA, Geiger MJ, McNabb MA, Cummings SR. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. Journal of Bone and Mineral Research. 2005;20(11):1912-20.
  • Schulz E, Arfai K, Liu X, Sayre J, Gilsanz V. Aortic calcification and the risk of osteoporosis and fractures. The Journal of Clinical Endocrinology & Metabolism. 2004;89(9):4246-53.
  • Naves M, Rodríguez-García M, Díaz-López JB, Gómez-Alonso C, Cannata-Andía JB. Progression of vascular calcifications is associated with greater bone loss and increased bone fractures. Osteoporosis International. 2008;19:1161-6.
  • Organization WH. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group [meeting held in Rome from 22 to 25 June 1992]: World Health Organization; 1994.
  • Armstrong WF, Ryan T. Feigenbaum's echocardiography: Lippincott Williams & Wilkins; 2012.
  • Abramowitz Y, Jilaihawi H, Chakravarty T, Mack MJ, Makkar RR. Mitral annulus calcification. Journal of the American College of Cardiology. 2015;66(17):1934-41.
  • Coffey S, Cox B, Williams MJ. The prevalence, incidence, progression, and risks of aortic valve sclerosis: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2014;63(25 Part A):2852-61.
  • Nam H-S, Shin M-H, Kweon S-S, Park K-S, Sohn S-J, Rhee J-A, et al. Association of estrogen receptor-α gene polymorphisms with bone mineral density in postmenopausal Korean women. Journal of bone and mineral metabolism. 2005;23:84-9.
  • Uçar M, Demir H. The Relationship of Brain Natriuretic Peptide Level with Biochemical Markers, Bone Mineral Density and Progenitor Factors in Rats with Experimental Osteoporosis. Journal of Anatolian Medical Research. 2022;7(1):5-12.
  • Carrai P, Camarri S, Pondrelli CR, Gonnelli S, Caffarelli C. Calcification of cardiac valves in metabolic bone disease: an updated review of clinical studies. Clinical Interventions in Aging. 2020:1085-95.
  • Arici A, Sozen I. Expression, menstrual cycle-dependent activation, and bimodal mitogenic effect of transforming growth factor-β1 in human myometrium and leiomyoma. American journal of obstetrics and gynecology. 2003;188(1):76-83.
  • Di Minno A, Zanobini M, Myasoedova VA, Valerio V, Songia P, Saccocci M, et al. Could circulating fetuin A be a biomarker of aortic valve stenosis? International journal of cardiology. 2017;249:426-30.
  • Carracedo M, Bäck M. Fetuin A in aortic stenosis and valve calcification: not crystal clear. International journal of cardiology. 2018;265:77-8.
  • Aylin S, Uslu T. The relationship between fetuin-A and bone mineral density in postmenopausal osteoporosis. Archives of Rheumatology. 2013;28(3):195-201.
  • Massera D, Trivieri MG, Andrews JP, Sartori S, Abgral R, Chapman AR, et al. Disease activity in mitral annular calcification: a multimodality study. Circulation: Cardiovascular Imaging. 2019;12(2):e008513.
  • von Mühlen DG, Greendale GA, Garland CF, Wan L, Barrett- Connor E. Vitamin D, parathyroid hormone levels and bone mineral density in community-dwelling older women: the Rancho Bernardo Study. Osteoporosis International. 2005;16:1721-6.
  • Lee T-L, Lee M-H, Chen Y-C, Lee Y-C, Lai T-C, Lin HY-H, et al. Vitamin D attenuates ischemia/reperfusion-induced cardiac injury by reducing mitochondrial fission and mitophagy. Frontiers in Pharmacology. 2020;11:604700.
  • Verdoia M, Pergolini P, Rolla R, Nardin M, Schaffer A, Barbieri L, et al. Impact of high-dose statins on vitamin D levels and platelet function in patients with coronary artery disease. Thrombosis Research. 2017;150:90-5.
  • Christodoulidis G, Vittorio TJ, Fudim M, Lerakis S, Kosmas CE. Inflammation in coronary artery disease. Cardiology in review. 2014;22(6):279-88.
  • Chitalia N, Ismail T, Tooth L, Boa F, Hampson G, Goldsmith D, et al. Impact of vitamin D supplementation on arterial vasomotion, stiffness and endothelial biomarkers in chronic kidney disease patients. PloS one. 2014;9(3):e91363.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Orijinal Araştırma
Yazarlar

Sevinç Külekçioğlu 0000-0003-3248-4014

Hakan Guven 0000-0001-6326-663X

Aydın Dursun 0000-0003-2792-7685

Mehmet Cem Başel 0000-0002-5077-0527

Erken Görünüm Tarihi 3 Ocak 2025
Yayımlanma Tarihi 3 Ocak 2025
Gönderilme Tarihi 30 Kasım 2024
Kabul Tarihi 23 Aralık 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 7 Sayı: 3

Kaynak Göster

EndNote Külekçioğlu S, Guven H, Dursun A, Başel MC (01 Ocak 2025) The Relationship Between Bone Mineral Density and Aortic Valve- Mitral Valve Calcification in Postmenopausal Women. Ege Tıp Bilimleri Dergisi 7 3 67–73.

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