03097nas a2200409 4500008004100000022001400041245013700055210006900192260001600261300001100277490000700288520191300295653000902208653002202217653001702239653002602256653002302282653001502305653002802320653001902348653002402367653001102391653002202402653002502424653001102449653000902460653001702469100002002486700001602506700002302522700002402545700001802569700002002587700002302607700002202630856003502652 2007 eng d a1558-359700aClinical factors, but not C-reactive protein, predict progression of calcific aortic-valve disease: the Cardiovascular Health Study.0 aClinical factors but not Creactive protein predict progression o c2007 Nov 13 a1992-80 v503 a

OBJECTIVES: The purpose of this study was to examine the relationship between C-reactive protein (CRP) and calcific aortic valve disease in a large, randomly selected, population-based cohort.

BACKGROUND: The pathobiology of calcific aortic stenosis involves an active inflammatory, atheromatous, osteogenic process. Elevations in CRP, a measure of systemic inflammation, have been associated with aortic stenosis.

METHODS: Two-dimensional and Doppler echocardiography and CRP measurement were performed at baseline in 5,621 participants in the Cardiovascular Health Study. Multivariable analysis was used to identify CRP as a predictor of baseline and incident aortic stenosis.

RESULTS: At a mean echocardiographic follow-up of 5 years, 9% of subjects with aortic sclerosis progressed to some degree of aortic stenosis. Increasing age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.16; p < 0.001) and male gender (OR 3.05, 95% CI 1.76 to 5.27; p < 0.001) were related to risk of incident aortic stenosis, whereas increasing height (OR 0.96, 95% CI 0.94 to 0.99; p = 0.013) and African-American ethnicity conveyed a lower risk (OR 0.49, 95% CI 0.25 to 0.95; p = 0.035). C-reactive protein, treated as a continuous variable, was not associated with baseline aortic stenosis, progression to aortic sclerosis (adjusted OR 0.93, 95% CI 0.85 to 1.02; p = 0.107), or progression to aortic stenosis (adjusted OR 0.85, 95% CI 0.70 to 1.03; p = 0.092).

CONCLUSIONS: In this large population-based cohort, approximately 9% of subjects with aortic sclerosis progressed to aortic stenosis over a 5-year follow-up period. There was no association between CRP levels and the presence of calcific aortic-valve disease or incident aortic stenosis. C-reactive protein appears to be a poor predictor of subclinical calcific aortic-valve disease.

10aAged10aAged, 80 and over10aAortic Valve10aAortic Valve Stenosis10aC-Reactive Protein10aCalcinosis10aCardiovascular Diseases10aCohort Studies10aDisease Progression10aFemale10aFollow-Up Studies10aHeart Valve Diseases10aHumans10aMale10aRisk Factors1 aNovaro, Gian, M1 aKatz, Ronit1 aAviles, Ronnier, J1 aGottdiener, John, S1 aCushman, Mary1 aPsaty, Bruce, M1 aOtto, Catherine, M1 aGriffin, Brian, P uhttps://chs-nhlbi.org/node/99703260nas a2200361 4500008004100000022001400041245018700055210006900242260001600311300001200327490000700339520214800346653000902494653002602503653001002529653002102539653001502560653001902575653001102594653001102605653003102616653000902647653002602656653002602682100002502708700002002733700002002753700002002773700001802793700002702811700002402838856003602862 2011 eng d a1558-359700aAssociation of annular calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults: the cardiovascular health study.0 aAssociation of annular calcification and aortic valve sclerosis  c2011 May 24 a2172-800 v573 a

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.

10aAged10aAortic Valve Stenosis10aBrain10aBrain Infarction10aCalcinosis10aCohort Studies10aFemale10aHumans10aMagnetic Resonance Imaging10aMale10aMitral Valve Stenosis10aRetrospective Studies1 aRodriguez, Carlos, J1 aBartz, Traci, M1 aLongstreth, W T1 aKizer, Jorge, R1 aBarasch, Eddy1 aLloyd-Jones, Donald, M1 aGottdiener, John, S uhttps://chs-nhlbi.org/node/1292