RT Journal Article
SR Electronic
T1 Association Between Aortic Valve Calcification and Myocardial Ischemia, Especially in Asymptomatic Patients
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1216
OP 1221
DO 10.2967/jnumed.111.099275
VO 53
IS 8
A1 Ryo Yamazato
A1 Hideya Yamamoto
A1 Futoshi Tadehara
A1 Hiroki Teragawa
A1 Satoshi Kurisu
A1 Yoshihiro Dohi
A1 Ken Ishibashi
A1 Eiji Kunita
A1 Hiroto Utsunomiya
A1 Toshiharu Oka
A1 Yasuki Kihara
YR 2012
UL http://jnm.snmjournals.org/content/53/8/1216.abstract
AB Aortic valve calcification (AVC) is recognized as a manifestation of systemic arteriosclerosis. However, it is unclear whether AVC is associated with myocardial ischemia. Stress myocardial perfusion SPECT (MPS) is widely used for the diagnosis of myocardial ischemia. However, routine MPS is not recommended, particularly in asymptomatic patients. Accordingly, we investigated the hypothesis that the presence of AVC is strongly associated with inducible myocardial ischemia, even among asymptomatic patients. Methods: We investigated 669 consecutive patients who underwent both adenosine stress 201Tl MPS and echocardiography. We evaluated the extent and severity of myocardial ischemia by the summed difference score (SDS). We defined the presence of myocardial ischemia as SDS ≥ 3 and moderate to severe ischemia as SDS ≥ 8. We classified the severity of AVC according to the number of affected aortic leaflets. We also compared the mean SDS and the prevalence of SDS ≥ 3 and SDS ≥ 8 among patients stratified by the severity of AVC. Results: The presence of AVC was significantly associated with myocardial ischemia (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.10–2.23; P = 0.013) and moderate to severe ischemia (OR, 2.16; 95% CI, 1.26–3.80; P = 0.0061). In 311 asymptomatic patients, AVC was strongly associated with moderate to severe ischemia (OR, 4.31; 95% CI, 1.67–12.8; P = 0.0043). However, the SDS value and the prevalence of SDS ≥ 3 and SDS ≥ 8 did not increase with increasing number of affected aortic leaflets. Conclusion: The presence of AVC may be associated with the presence of myocardial ischemia, particularly in asymptomatic patients. However, we found no association between the extent of AVC and inducible myocardial ischemia. The presence of AVC may be a useful anatomic marker to help identify patients at high risk of myocardial ischemia, particularly asymptomatic patients.