Aortic Valve Calcification: Assessment of Cardiovascular Risk Factors and Bone Mineral Density in Patients Undergoing Coronary Angiography

Öz

Objective: Aortic valve calcification (AVC) appears to have high incidence of cardiovascular risk factors and can be considered as a manifestation of atherosclerosis. Association between low bone mineral density (BMD) and increased prevalence of aortic calcification has been shown in older women mainly in population based studies. However, some studies have reported lack of association between BMD and aortic calcification. Accordingly we aimed to assess AVC in patients undergoing coronary angiography and to compare cardiovascular risk factors and BMD of patients with and without AVC. Materials and Methods: Study population consisted of 585 consecutive patients (372 male, 213 female mean age 5910) who underwent coronary angiography. Complete transthoracic echocardiography studies were performed in all patients. AVC was defined as bright dense echos of >1 mm size on one or more cusps and decreased mobility of the involved cusp. All patients were referred to Nuclear Medicine department to measure bone mineral density (T score) using the dual energy x-ray absorptiometry method (DEXA). Age, sex, body mass index, hypertension, diabetes mellitus, coronary artery disease, hypercholesterolemia, and smoking status were recorded in all patients. Results: The prevalence of AVC in our study population was found to be 27% (160/585). There were not statistically significant differences between two groups in respect to diabetes mellitus, hypercholesterolemia, smoking status (p>0.05 for all). Age and hypertension were found to be independent positive risk factors for AVC, where as body mass index was found to be negatively and independently associated with AVC. Presence of coronary artery disease was significantly higher in patients with AVC compared to those without AVC however it was not found to be associated with AVC. Neither T score nor age- and gender adjusted T score were found to be associated with AVC. Conclusion: We have demonstrated that age, hypertension, and body mass index are independently associated with AVC. Age-gender adjusted T score measuring BMD is found to be independent of AVC. Although we have shown absence of association between coronary artery disease and AVC, this issue remains to be clarified in further clinical studies. Key words: Aortic valve calcification, Bone mineral density, Cardiovascular risk factors, Coronary artery disease, Atherosclerosis, Osteoporosis, T score

Anahtar Kelimeler

• Aortic valve calcification, Bone mineral density, Cardiovascular risk factors, Coronary artery disease, Atherosclerosis, Osteoporosis, T score

Aort Kapak kalsifikasyonu: Koroner Anjiografi Yapılan Hastalarda Kardiyovasküler Risk Faktörlerinin ve Kemik Mineral Dansitesinin Değerlendirilmesi

Öz

Amaç: Aort kapak kalsifikasyonu (AKK) yüksek kardiyovasküler risk insidansına sahip görünmekte olup, aterosklerozun bir sonucu olarak kabul edilebilir. Düşük kemik mineral dansitesi ve artmış aort kalsifikasyon prevalensi arasındaki ilişki esas olarak toplum tabanlı çalışmalarda yaşlı bayanlarda gösterilmiştir. Ancak bazı çalışmalar kemik mineral dansitesi ile aort kalsifikasyonu arasında ilişki olmadığını bildirmiştir. Bu yüzden. biz koroner angiografi yapılan hastalarda AKK'nu değerlendirmeyi ve AKK olan ve olmayan hastaların kardiyovasküler risk faktörlerini ve kemik mineral dansitelerini karşılaştırmayı amaçladık. Materyal ve metod: Çalışma populasyonu koroner angiografi yapılan 585 ardışık hasta (372 erkek, 213 kadın, ortalama yaş=59±10 yıl) içeriyordu. Bütün hastalara transtorasik ekokardiyografik inceleme yapıldı. AKK bir yada daha fazla küspis üzerinde birden fazla parlak yoğun ekoların izlenmesi ve tutulan küspisin azalmış hareketi olarak tanımlandı. Bütün hastalar dual energy x-ray absorpsiyometri (DEXA) yöntemi ile kemik mineral dansitesi (T scor) ölçümü için Nükleer Tıp bölümüne yönlendirildi. Tüm hastalarda yaş, cinsiyet, vücut kitle indeksi, hipertansiyon, diyabetes mellitus, koroner arter hastalığı, hiperkolesterolemi ve sigara içiciliği kaydedildi. Bulgular: Çalışmamızda AKK prevalensı %27 (160/585) bulundu. Her iki grup arasında diyabetes mellitus, hiperkolesterolemi ve sigara içiciliği yönünden istatistiksel olarak anlamlı fark yoktu (p>0.05 hepsi için). Yaş ve hipertansiyon AKK için bağımsız risk faktörü olmasına karşılık vücut kitle indeksi AKK için bağımsız ve negatif risk faktörü olarak saptandı. AKK ile ilişkili bulunmasada AKK olan grupta koroner arter hastalığı anlamlı oranda yüksek saptandı. Ne T skoru, ne de yaş ve cinsiyete uyarlanmış T skoru AKK ile ilişkili bulunmadı. Sonuç: Biz bu çalışmada yaş, hipertansiyon ve vücut kitle indeksi ile AKK arasında bağımsız ilişki olduğunu gösterdik. Kemik mineral dansite ölçümünde yaş-cinsiyet uyarlanmış T skoru AKK ile ilişkisiz bulundu. Her ne kadar çalışmamızda koroner arter hastalığı ile AKK arasında ilişki olmadığı gösterilmiş olsada bu konunun aydınlanması için ileri çalışmalara ihtiyaç vardır. Anahtar kelimeler: Aort kapak kalsifikasyonu, Kemik mineral dansitesi, Kardiyovasküler risk faktörleri, Koroner arter hastalığı, Ateroskleroz, Osteoporoz, T scor

Anahtar Kelimeler

• Aort kapak kalsifikasyonu, Kemik mineral dansitesi, Kardiyovasküler risk faktörleri, Koroner arter hastalığı, Ateroskleroz, Osteoporoz, T scor

Kaynakça

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