Associations of LV hypertrophy with prevalent and incident valve calcification: Multi-ethnic study of atherosclerosis

Sammy Elmariah, Joseph A C Delaney, David A. Bluemke, Matthew J. Budoff, Kevin D. O'Brien, Valentin Fuster, Richard A. Kronmal, Jonathan L. Halperin

Research output: Contribution to journalArticle

Abstract

The aim of this study was to evaluate the relationship between percentage of predicted left ventricular mass (%PredLVM) and valve calcification in the MESA (Multi-Ethnic Study of Atherosclerosis) study. Cardiac valve calcification has been associated with left ventricular hypertrophy (LVH), which portends cardiovascular events. However, this relationship and its mediators are poorly understood. The MESA study is a longitudinal cohort study of men and women 45 to 84 years of age without clinical cardiovascular disease in whom serial cardiac magnetic resonance and computed tomography imaging were performed. The relationships between baseline %PredLVM and the prevalence, severity, and incidence of aortic valve (AVC) and mitral annulus calcification (MAC) were determined by regression modeling. Prevalent AVC was observed in 630, and MAC was observed in 442 of 5,042 subjects (median 55.9 and 71.1 Agatston units, respectively). After adjustment for age, sex, body mass index (BMI), ethnicity, socioeconomic status, physical activity, diabetes, cholesterol levels, blood pressure, smoking, kidney function, serum lipids, and antihypertensive and statin medications, %PredLVM was associated with prevalent AVC (odds ratio [OR]: 1.18/SD increase in %PredLVM [95% confidence interval (CI): 1.08 to 1.30]; p = 0.0004) and MAC (OR: 1.18 [95% CI: 1.06 to 1.32]; p = 0.002). Similarly, %PredLVM was associated with increased severity of prevalent AVC (risk difference = 0.26 [95% CI: 0.15 to 0.38]; p <0.0001) and MAC (risk difference = 0.20 [95% CI: 0.03 to 0.37]; p = 0.02). During follow-up (mean 2.4 ± 0.9 years), 153 subjects (4%) developed AVC, and 198 (5%) developed MAC. The %PredLVM was associated with incident AVC (OR: 1.24 [95% CI: 1.04 to 1.47]; p = 0.02) and MAC (OR: 1.18 [95% CI: 1.01 to 1.40]; p = 0.04). Further adjustment for inflammatory markers and coronary artery calcification did not attenuate these associations. Specifically, concentric LVH most strongly predicted incident valve calcification. Within the MESA cohort, LVH was associated with prevalence, severity, and incidence of valve calcification independent of hypertension and other identified confounders.

Original languageEnglish (US)
Pages (from-to)781-788
Number of pages8
JournalJACC: Cardiovascular Imaging
Volume5
Issue number8
DOIs
StatePublished - Aug 2012
Externally publishedYes

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Hypertrophy
Atherosclerosis
Confidence Intervals
Left Ventricular Hypertrophy
Odds Ratio
Cohort Studies
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Heart Valves
Incidence
Aortic Valve
Social Class
Antihypertensive Agents
Longitudinal Studies
Coronary Vessels
Body Mass Index
Cardiovascular Diseases
Magnetic Resonance Spectroscopy
Smoking
Cholesterol
Tomography

Keywords

  • %LVVol
  • %PredLVM
  • Agatston units
  • aortic valve calcification
  • AU
  • AVC
  • BMI
  • body mass index
  • CI
  • confidence interval
  • high-sensitivity C-reactive protein
  • hs-CRP
  • IL
  • interleukin
  • left ventricular
  • left ventricular hypertrophy
  • LV
  • LVH
  • MAC
  • mitral annulus calcification
  • odds ratio
  • OR
  • percentage of predicted left ventricular end diastolic volume
  • percentage of predicted left ventricular mass

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Elmariah, S., Delaney, J. A. C., Bluemke, D. A., Budoff, M. J., O'Brien, K. D., Fuster, V., ... Halperin, J. L. (2012). Associations of LV hypertrophy with prevalent and incident valve calcification: Multi-ethnic study of atherosclerosis. JACC: Cardiovascular Imaging, 5(8), 781-788. https://doi.org/10.1016/j.jcmg.2011.12.025

Associations of LV hypertrophy with prevalent and incident valve calcification : Multi-ethnic study of atherosclerosis. / Elmariah, Sammy; Delaney, Joseph A C; Bluemke, David A.; Budoff, Matthew J.; O'Brien, Kevin D.; Fuster, Valentin; Kronmal, Richard A.; Halperin, Jonathan L.

In: JACC: Cardiovascular Imaging, Vol. 5, No. 8, 08.2012, p. 781-788.

Research output: Contribution to journalArticle

Elmariah, S, Delaney, JAC, Bluemke, DA, Budoff, MJ, O'Brien, KD, Fuster, V, Kronmal, RA & Halperin, JL 2012, 'Associations of LV hypertrophy with prevalent and incident valve calcification: Multi-ethnic study of atherosclerosis', JACC: Cardiovascular Imaging, vol. 5, no. 8, pp. 781-788. https://doi.org/10.1016/j.jcmg.2011.12.025
Elmariah, Sammy ; Delaney, Joseph A C ; Bluemke, David A. ; Budoff, Matthew J. ; O'Brien, Kevin D. ; Fuster, Valentin ; Kronmal, Richard A. ; Halperin, Jonathan L. / Associations of LV hypertrophy with prevalent and incident valve calcification : Multi-ethnic study of atherosclerosis. In: JACC: Cardiovascular Imaging. 2012 ; Vol. 5, No. 8. pp. 781-788.
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T1 - Associations of LV hypertrophy with prevalent and incident valve calcification

T2 - Multi-ethnic study of atherosclerosis

AU - Elmariah, Sammy

AU - Delaney, Joseph A C

AU - Bluemke, David A.

AU - Budoff, Matthew J.

AU - O'Brien, Kevin D.

AU - Fuster, Valentin

AU - Kronmal, Richard A.

AU - Halperin, Jonathan L.

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N2 - The aim of this study was to evaluate the relationship between percentage of predicted left ventricular mass (%PredLVM) and valve calcification in the MESA (Multi-Ethnic Study of Atherosclerosis) study. Cardiac valve calcification has been associated with left ventricular hypertrophy (LVH), which portends cardiovascular events. However, this relationship and its mediators are poorly understood. The MESA study is a longitudinal cohort study of men and women 45 to 84 years of age without clinical cardiovascular disease in whom serial cardiac magnetic resonance and computed tomography imaging were performed. The relationships between baseline %PredLVM and the prevalence, severity, and incidence of aortic valve (AVC) and mitral annulus calcification (MAC) were determined by regression modeling. Prevalent AVC was observed in 630, and MAC was observed in 442 of 5,042 subjects (median 55.9 and 71.1 Agatston units, respectively). After adjustment for age, sex, body mass index (BMI), ethnicity, socioeconomic status, physical activity, diabetes, cholesterol levels, blood pressure, smoking, kidney function, serum lipids, and antihypertensive and statin medications, %PredLVM was associated with prevalent AVC (odds ratio [OR]: 1.18/SD increase in %PredLVM [95% confidence interval (CI): 1.08 to 1.30]; p = 0.0004) and MAC (OR: 1.18 [95% CI: 1.06 to 1.32]; p = 0.002). Similarly, %PredLVM was associated with increased severity of prevalent AVC (risk difference = 0.26 [95% CI: 0.15 to 0.38]; p <0.0001) and MAC (risk difference = 0.20 [95% CI: 0.03 to 0.37]; p = 0.02). During follow-up (mean 2.4 ± 0.9 years), 153 subjects (4%) developed AVC, and 198 (5%) developed MAC. The %PredLVM was associated with incident AVC (OR: 1.24 [95% CI: 1.04 to 1.47]; p = 0.02) and MAC (OR: 1.18 [95% CI: 1.01 to 1.40]; p = 0.04). Further adjustment for inflammatory markers and coronary artery calcification did not attenuate these associations. Specifically, concentric LVH most strongly predicted incident valve calcification. Within the MESA cohort, LVH was associated with prevalence, severity, and incidence of valve calcification independent of hypertension and other identified confounders.

AB - The aim of this study was to evaluate the relationship between percentage of predicted left ventricular mass (%PredLVM) and valve calcification in the MESA (Multi-Ethnic Study of Atherosclerosis) study. Cardiac valve calcification has been associated with left ventricular hypertrophy (LVH), which portends cardiovascular events. However, this relationship and its mediators are poorly understood. The MESA study is a longitudinal cohort study of men and women 45 to 84 years of age without clinical cardiovascular disease in whom serial cardiac magnetic resonance and computed tomography imaging were performed. The relationships between baseline %PredLVM and the prevalence, severity, and incidence of aortic valve (AVC) and mitral annulus calcification (MAC) were determined by regression modeling. Prevalent AVC was observed in 630, and MAC was observed in 442 of 5,042 subjects (median 55.9 and 71.1 Agatston units, respectively). After adjustment for age, sex, body mass index (BMI), ethnicity, socioeconomic status, physical activity, diabetes, cholesterol levels, blood pressure, smoking, kidney function, serum lipids, and antihypertensive and statin medications, %PredLVM was associated with prevalent AVC (odds ratio [OR]: 1.18/SD increase in %PredLVM [95% confidence interval (CI): 1.08 to 1.30]; p = 0.0004) and MAC (OR: 1.18 [95% CI: 1.06 to 1.32]; p = 0.002). Similarly, %PredLVM was associated with increased severity of prevalent AVC (risk difference = 0.26 [95% CI: 0.15 to 0.38]; p <0.0001) and MAC (risk difference = 0.20 [95% CI: 0.03 to 0.37]; p = 0.02). During follow-up (mean 2.4 ± 0.9 years), 153 subjects (4%) developed AVC, and 198 (5%) developed MAC. The %PredLVM was associated with incident AVC (OR: 1.24 [95% CI: 1.04 to 1.47]; p = 0.02) and MAC (OR: 1.18 [95% CI: 1.01 to 1.40]; p = 0.04). Further adjustment for inflammatory markers and coronary artery calcification did not attenuate these associations. Specifically, concentric LVH most strongly predicted incident valve calcification. Within the MESA cohort, LVH was associated with prevalence, severity, and incidence of valve calcification independent of hypertension and other identified confounders.

KW - %LVVol

KW - %PredLVM

KW - Agatston units

KW - aortic valve calcification

KW - AU

KW - AVC

KW - BMI

KW - body mass index

KW - CI

KW - confidence interval

KW - high-sensitivity C-reactive protein

KW - hs-CRP

KW - IL

KW - interleukin

KW - left ventricular

KW - left ventricular hypertrophy

KW - LV

KW - LVH

KW - MAC

KW - mitral annulus calcification

KW - odds ratio

KW - OR

KW - percentage of predicted left ventricular end diastolic volume

KW - percentage of predicted left ventricular mass

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