Association of annular calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults: The cardiovascular health study

Carlos J. Rodriguez, Traci M. Bartz, W. T. Longstreth, Jorge Kizer, Eddy Barasch, Donald M. Lloyd-Jones, John S. Gottdiener

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2172-2180
Number of pages9
JournalJournal of the American College of Cardiology
Volume57
Issue number21
DOIs
StatePublished - May 24 2011
Externally publishedYes

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Independent Living
Sclerosis
Magnetic Resonance Imaging
Health
Brain
Stroke
Blood Pressure
Transient Ischemic Attack
Calcification of Aortic Valve
HDL Cholesterol
Coronary Disease
Dementia
Creatinine
Body Mass Index
Heart Failure
Smoking
Odds Ratio
Cholesterol
Confidence Intervals
Exercise

Keywords

  • aortic valve
  • calcification
  • covert brain infarcts
  • epidemiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Association of annular calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults : The cardiovascular health study. / Rodriguez, Carlos J.; Bartz, Traci M.; Longstreth, W. T.; Kizer, Jorge; Barasch, Eddy; Lloyd-Jones, Donald M.; Gottdiener, John S.

In: Journal of the American College of Cardiology, Vol. 57, No. 21, 24.05.2011, p. 2172-2180.

Research output: Contribution to journalArticle

Rodriguez, Carlos J. ; Bartz, Traci M. ; Longstreth, W. T. ; Kizer, Jorge ; Barasch, Eddy ; Lloyd-Jones, Donald M. ; Gottdiener, John S. / Association of annular calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults : The cardiovascular health study. In: Journal of the American College of Cardiology. 2011 ; Vol. 57, No. 21. pp. 2172-2180.
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abstract = "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.",
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