CLINICAL STUDY: VALVE DISEASE
Association of mitral annulus calcification, aortic valve sclerosis and aortic root calcification with abnormal myocardial perfusion single photon emission tomography in subjects age  65 years old
Doo-Soo Jeon, MDa,
Shaul Atar, MDa,
Andrea V. Brasch, MDa,
Huai Luo, MDa,
James Mirocha, MSa,
Tasneem Z. Naqvi, MD, FACCa,
Robert Kraus, MD, FACCa,
Daniel S. Berman, MD, FACCa and
Robert J. Siegel, MD, FACC*,a
a Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California., USA
Manuscript received November 17, 2000;
revised manuscript received August 3, 2001,
accepted September 4, 2001.
* Reprint requests and correspondence: Dr. Robert J. Siegel, Cardiac Non-Invasive Laboratory, Room 5335, Cedars-Sinai Medical Center, Los Angeles, California 90048 USA
Siegel{at}cshs.org
OBJECTIVES
We examined the hypothesis that mitral annulus calcification (MAC), aortic valve sclerosis (AVS) and aortic root calcification (ARC) are associated with coronary artery disease (CAD) in subjects age  65 years.
BACKGROUND
Mitral annulus calcification, AVS and ARC frequently coexist and are associated with coronary risk factors and CAD in the elderly.
METHODS
We studied 338 subjects age 65 years who underwent evaluation of chest pain with myocardial perfusion single photon emission computed tomography (SPECT) and a two-dimensional transthoracic echocardiogram for other indications. The association of MAC, AVS and ARC with abnormal SPECT was evaluated by using chi-square analyses and logistic regression analyses.
RESULTS
Compared with no or one calcium deposit and no or one coronary risk factor other than diabetes, multiple ( 2) calcium (or sclerosis) deposits with diabetes or multiple (2) coronary risk factors were significantly associated with abnormal SPECT in women age 55 years old (odds ratio [OR], 20.00), in women age >55 years old (OR, 10.00) and in men age 55 years old (OR, 5.55). Multivariate analyses identified multiple calcium deposits as a significant predictor for an abnormal SPECT in women (p < 0.001), younger subjects age 55 years (p < 0.05) and the total group of subjects (p < 0.01).
CONCLUSIONS
When coronary risk factors are also taken into consideration, the presence of multiple calcium deposits in the mitral annulus, aortic valve or aortic root appears to be a marker of CAD in men 55 years old and women.
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Abbreviations and Acronyms
| | ARC | = aortic root calcification | | AVS | = aortic valve sclerosis | | CAD | = coronary artery disease | | CI | = confidence interval | | MAC | = mitral annulus calcification | | OR | = odds ratio | | SPECT | = single photon emission computed tomography | | SSS | = summed stress score | | TTE | = transthoracic echocardiogram |
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