Association of Annular Calcification and Aortic Valve Sclerosis With Brain Findings on Magnetic Resonance Imaging in Community Dwelling Older Adults The Cardiovascular Health Study

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:57

Editorial Material

Rodriguez, Carlos J.¹  Bartz, Traci M.²  Longstreth, W. T., Jr.^3,4  Kizer, Jorge R.^5,6  Barasch, Eddy^7,8  Lloyd-Jones, Donald M.⁹  Gottdiener, John S.¹⁰ 

[1] Wake Forest Univ, Sch Med, Div Publ Hlth Sci, Dept Epidemiol & Med, Winston Salem, NC 27157 USA

[2] Univ Washington, Dept Biostat, Seattle, WA 98195 USA

[3] Univ Washington, Dept Neurol, Seattle, WA 98195 USA

[4] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

[5] Weill Cornell Med Coll, Dept Med, New York, NY USA

[6] Weill Cornell Med Coll, Dept Publ Hlth, New York, NY USA

[7] St Francis Hosp, Roslyn, NY USA

[8] SUNY Stony Brook, Stony Brook, NY 11794 USA

[9] Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL 60611 USA

[10] Univ Maryland, Dept Med, Baltimore, MD 21201 USA

关键词: aortic valve;    calcification;    covert brain infarcts;    epidemiology;   

DOI  :  10.1016/j.jacc.2011.01.034

来源: Elsevier

【 摘 要 】

Objectives The objective of this study was to investigate the associations of mitral annular calcification, aortic annular calcification, and aortic valve sclerosis with covert magnetic resonance imaging (MRI)-defined brain infarcts. Background Clinically silent brain infarcts defined by MRI are associated with increased risk for cognitive decline, dementia, and future overt stroke. Left-sided cardiac valvular and annular calcifications are suspected as risk factors for clinical ischemic stroke. Methods A total of 2,680 CHS (Cardiovascular Health Study) participants without clinical histories of stroke or transient ischemic attack underwent brain MRI in 1992 and 1993, 1 to 2 years before echocardiographic exams (1994 to 1995). Results The mean age of the participants was 74.5 +/- 4.8 years, and 39.3% were men. The presence of any annular or valvular calcification (mitral annular calcification, aortic annular calcification, or aortic valve sclerosis), mitral annular calcification alone, or aortic annular calcification alone was significantly associated with a higher prevalence of covert brain infarcts in unadjusted analyses (p < 0.01 for all). In models adjusted for age, sex, race, body mass index, physical activity, creatinine, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, diabetes, coronary heart disease, and congestive heart failure, the presence of any annular or valve calcification remained associated with covert brain infarcts (risk ratio: 1.24; 95% confidence interval: 1.05 to 1.47). The degree of annular or valvular calcification severity showed a direct relation with the presence of covert MRI findings. Conclusions Left-sided cardiac annular and valvular calcifications are associated with covert MRI-defined brain infarcts. Further study is warranted to identify mechanisms and determine whether intervening in the progression of annular and valvular calcification could reduce the incidence of covert brain infarcts as well as the associated risk for cognitive impairment and future stroke. (J Am Coll Cardiol 2011; 57: 2172-80) (C) 2011 by the American College of Cardiology Foundation

【 授权许可】

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