Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 May;21(5):963-73.
doi: 10.1007/s00330-010-1995-0. Epub 2010 Nov 8.

The association of incidentally detected heart valve calcification with future cardiovascular events

Martijn J A Gondrie  1 , Yolanda van der Graaf, Peter C Jacobs, Ay L Oen, Willem P Th M Mali; PROVIDI Study Group
Collaborators, Affiliations

The association of incidentally detected heart valve calcification with future cardiovascular events

Martijn J A Gondrie et al. Eur Radiol. 2011 May.

Abstract

Objectives: This study aims to investigate the prognostic value of incidental aortic valve calcification (AVC), mitral valve calcification (MVC) and mitral annular calcification (MAC) for cardiovascular events and non-rheumatic valve disease in particular on routine diagnostic chest CT.

Methods: The study followed a case-cohort design. 10410 patients undergoing chest CT were followed for a median period of 17 months. Patients referred for cardiovascular disease were excluded. A random sample of 1285 subjects and the subjects who experienced an endpoint were graded for valve calcification by three reviewers. Cox-proportional hazard analysis was performed to evaluate the prognostic value.

Results: 515 cardiovascular events were ascertained. Compared with patients with no valve calcification, patients with severe AVC, MVC or MAC had respectively 2.03 (1.48-2.78), 2.08 (1.04-4.19) and 1.53 (1.13-2.08) increased risks of experiencing an event during follow-up. For valve endpoints the hazard ratios were respectively 14.57 (5.19-40.53), 8.78 (2.33-33.13) and 2.43 (1.18-4.98).

Conclusion: Incidental heart valve calcification, detected on routine chest CT is an independent predictor of future cardiovascular events. The study emphasises how incidental imaging findings can contribute to clinical care. It is a step in the process of composing an evidence-based approach in the reporting of incidental subclinical findings.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flowchart of study design. CBS: Dutch central bureau of statistics. LMR: Dutch medical data registration
Fig. 2
Fig. 2
Image examples. Upper left image shows two affected leaflets of the aortic valve. The upper right shows one calcified leaflet of the aortic valve. The lower left image shows annular calcification of the mitral valve and the lower right image shows an affected leaflet of the mitral valve
Fig. 3
Fig. 3
Proportion of patients free of cardiovascular events according the aortic valve score adjusted for age, sex, imaging indication, referral centre. The dotted line is included as an example and indicates the proportion of severly affected patients free of cardiovascular events after 3 years of follow-up
Fig. 4
Fig. 4
Proportion of patients free of cardiovascular event according the mitral valve score adjusted for age, sex, imaging indication, referral centre. The dotted line is included as an example and indicates the proportion of severely affected patients free of cardiovascular events after 3 years’ follow-up
See this image and copyright information in PMC

References

    1. Horton KM, Post WS, et al. Prevalence of significant noncardiac findings on electron-beam computed tomography coronary artery calcium screening examinations. Circulation. 2002;5:532–534. doi: 10.1161/01.CIR.0000027136.56615.DE. - DOI - PubMed
    1. Jacobs PC, Mali WP, et al. Prevalence of incidental findings in computed tomographic screening of the chest: a systematic review. J Comput Assist Tomogr. 2008;2:214–221. doi: 10.1097/RCT.0b013e3181585ff2. - DOI - PubMed
    1. Truong MT, Munden RF. Lung cancer screening. Curr Oncol Rep. 2003;4:309–312. doi: 10.1007/s11912-003-0072-0. - DOI - PubMed
    1. Wisnivesky JP, Mushlin AI, et al. The cost-effectiveness of low-dose CT screening for lung cancer: preliminary results of baseline screening. Chest. 2003;2:614–621. doi: 10.1378/chest.124.2.614. - DOI - PubMed
    1. Song ZZ, Ma J. Incidental detection of aortic valve calcification at CT. Radiology. 2007;2:611–612. doi: 10.1148/radiol.2452070152. - DOI - PubMed

Publication types