scholarly journals Aortic Valve Calcification is Associated with Future Cognitive Impairment

2021 ◽  
pp. 1-7
Author(s):  
Hojune E. Chung ◽  
Jessica Chen ◽  
Dhairyasheel Ghosalkar ◽  
Jared L. Christensen ◽  
Alice J. Chu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Aortic Valve ◽  
Lung Cancer Screening ◽  
Continuous Variable ◽  
Smoking History ◽  
Event Analysis ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Ckd Stage ◽  
New Diagnosis

Background: While an association between atherosclerosis and dementia has been identified, few studies have assessed the longitudinal relationship between aortic valve calcification (AVC) and cognitive impairment (CI). Objective: We sought to determine whether AVC derived from lung cancer screening CT (LCSCT) was associated with CI in a moderate-to-high atherosclerotic risk cohort. Methods: This was a single site, retrospective analysis of 1401 U.S. veterans (65 years [IQI: 61, 68] years; 97%male) who underwent quantification of AVC from LCSCT indicated for smoking history. The primary outcome was new diagnosis of CI identified by objective testing (Mini-Mental Status Exam or Montreal Cognitive Assessment) or by ICD coding. Time-to-event analysis was carried out using AVC as a continuous variable. Results: Over 5 years, 110 patients (8%) were diagnosed with CI. AVC was associated with new diagnosis of CI using 3 Models for adjustment: 1) age (HR: 1.104; CI: 1.023–1.191; p = 0.011); 2) Model 1 plus hypertension, hyperlipidemia, diabetes, CKD stage 3 or higher (glomerular filtration rate <  60 mL/min) and CAD (HR: 1.097; CI: 1.014–1.186; p = 0.020); and 3) Model 2 plus CVA (HR: 1.094; CI: 1.011–1.182; p = 0.024). Sensitivity analysis demonstrated that the association between AVC and new diagnosis of CI remained significant upon exclusion of severe AVC (HR: 1.100 [1.013–1.194]; p = 0.023). Subgroup analysis demonstrated that this association remained significant when including education in the multivariate analysis (HR: 1.127 [1.030–1.233]; p = 0.009). Conclusion: This is the first study demonstrating that among mostly male individuals who underwent LCSCT, quantified aortic valve calcification is associated with new diagnosis of CI.

Abstract 16664: Aortic Valve Calcification is Prognostic for Mild Cognitive Impairment

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hojune E Chung ◽  
Jessica Chen ◽  
Jared L Christensen ◽  
Dhairyasheel S Ghosalkar ◽  
Cullen Soares ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Aortic Valve ◽  
Cox Regression ◽  
Smoking History ◽  
Secondary Outcome ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Multivariate Adjustment

Introduction: While an association between vascular disease and dementia has been identified, few studies have assessed the longitudinal relationship between aortic valve calcification (AVC) and mild cognitive impairment (MCI). We recently found AVC to be associated with increased atherosclerotic events, and we sought to determine the prognostic value of AVC derived from low dose, lung cancer screening computed tomography (LCSCT) for MCI in a moderate-to-high atherosclerotic risk cohort. Methods: This was a single site, retrospective analysis of 1401 U.S. veterans (65 years [IQI: 61, 68] years; 97% male), who underwent quantification of AVC from LCSCT indicated for smoking history. Exclusion criteria included lung cancer, prior aortic valve replacement and prior MCI diagnosis. The primary outcome was new diagnosis of MCI identified by objective testing (Mini-Mental Status Exam or Montreal Cognitive Assessment) or by ICD coding. Secondary outcome was nonfatal cerebrovascular accident (CVA). Time-to-event analysis was carried out using AVC as a continuous and a categorical variable, and multivariate adjustment included age, diabetes mellitus, glomerular filtration rate <60 mL/min, coronary artery disease, and prior CVA. Results: Over a 5-year follow up, 110 patients (8%) were newly diagnosed with MCI and 45 patients (3%) had CVA. By Cox regression, AVC was predictive of MCI (HR: 1.15 [1.07 -1.24], p<0.001) and the association remained significant after multivariate adjustment (HR: 1.09 [1.01-1.18], p=0.026). Non-zero AVC tertiles were: 0.1-115; 116-427; and ≥428 Agatston Units. AVC was associated with MCI at increasing tertiles, and after multivariate analysis, the association remained significant (HR: 1.89 [1.09-3.28], p=0.024 and HR: 1.80 [1.01-3.20], p=0.047; tertiles 2 and 3, respectively). AVC was also associated with CVA (HR: 1.17 [1.05-1.32], p=0.006); however, the association lost significance after multivariate adjustment (HR: 1.12 [0.99-1.26], p=0.080). Conclusions: To our knowledge, this is the first study demonstrating that quantification of AVC from LCSCT is predictive of MCI. The association may be in part due to atherosclerotic thromboembolic events as there was a trend toward increasing nonfatal CVA in this population.

scholarly journals Epicardial fat, cardiovascular risk factors and calcifications in patients with chronic kidney disease

2019 ◽  
Vol 13 (4) ◽  
pp. 571-579 ◽  
Author(s):  
Turgay Saritas ◽  
Sebastian Daniel Reinartz ◽  
Jennifer Nadal ◽  
Jonas Schmoee ◽  
Matthias Schmid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Aortic Valve ◽  
Coronary Artery Calcification ◽  
Risk Scores ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Ckd Stage

Abstract Background Epicardial adipose tissue (EAT) exerts cardiopathogenic effects, but the independent association between EAT and cardiovascular (CV) calcification in patients with chronic kidney disease (CKD) remains controversial. We therefore assessed the association between EAT, CV risk factors and CV calcifications. Methods 257 patients with CKD Stage 3 and/or overt proteinuria underwent quantification of EAT, coronary artery calcification and aortic valve calcification by computed tomography. Framingham and American College of Cardiology and American Heart Association (ACC-AHA) 10-year CV event risk scores were calculated for each patient. Results Using multivariable regression analysis, higher EAT was significantly associated with the majority of investigated risk factors {higher age: odds ratio [OR] 1.05/year [95% confidence interval (CI) 1.02–1.08]; male sex: OR 4.03 [95% CI 2.22–7.31]; higher BMI: OR 1.28/kg/m2 [95% CI 1.20–1.37]; former smoking: OR 1.84 [95% CI 1.07–3.17]; lower high-density lipoprotein cholesterol: OR 0.98/mg/dL [95% CI 0.96–1.00] and lower estimated glomerular filtration rate: OR 0.98/mL/min/1.73 m2 [95% CI 0.97–0.99]; all P &lt; 0.05} and was not associated with diabetes mellitus, hypertensive nephropathy, total cholesterol and albuminuria. EAT was positively associated with higher ACC-AHA and Framingham risk scores. EAT correlated with coronary artery calcification and aortic valve calcification [Spearman ρ = 0.388 (95% CI 0.287–0.532) and rrb = 0.409 (95% CI 0.310–0.556), respectively], but these correlations were dependent on CV risk factors. Conclusions The increase of EAT can be explained by individual CV risk factors and kidney function and correlates with 10-year risk for CV event scores, suggesting that EAT is a modifiable risk factor in patients with CKD. Although EAT correlates with CV calcifications, these relations depend on CV risk factors.

Synthetic Hydrogels Reveal the Role of the Matrix Microenvironment on Aortic Valve Calcification

2021 ◽  
Vol 5 (sup1) ◽  
pp. 73-73
Author(s):  
Megan E. Schroeder ◽  
Andrea Gonzalez Rodriguez ◽  
Kelly F. Speckl ◽  
Cierra J. Walker ◽  
Firaol S. Midekssa ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
The Matrix ◽  
Synthetic Hydrogels
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