Heart valve sclerosis predicts all-cause and cardiovascular mortality

Henry Völzke, Robin Haring, Roberto Lorbeer, Henri Wallaschofski, Thorsten Reffelmann, Klaus Empen, Rainer Rettig, Ulrich John, Stephan B. Felix, Marcus Dörr

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Objectives: Aortic valve sclerosis (AVS) and mitral annulus calcification (MAC) might predict future adverse events. We undertook the present study to investigate the association of AVS and MAC with all-cause and cardiovascular mortality. We further studied whether a combined presence of AVS and MAC is more strongly associated with mortality than the single items and sought to disclose possible gender differences in the investigated associations. Methods: We used data from 2081 participants aged ≥45 years (1063 women) of the Study of Health in Pomerania (SHIP). AVS and MAC were determined echocardiographically, and a heart valve sclerosis score was calculated by summing up the AVS and MAC variables. The median duration of mortality follow-up was 8.6 years (17,162 person-years). Results: There were 528 subjects (25.4%) with isolated AVS, 35 with isolated MAC (1.7%) and 89 with both AVS and MAC (4.3%). A total number of 228 deaths (11.0%) occurred during follow-up, including 133 (21.6%) with AVS and 95 subjects (6.5%) without AVS (incidence rate ratio 3.49, 95% CI 2.77; 4.40, p<. 0.001). Likewise, mortality rates were higher for subjects with MAC than subjects without MAC (incidence rate ratio 3.79, 95% CI 2.82; 5.02, p<. 0.001). Multivariable analyses revealed that the associations of AVS and MAC with all-cause and cardiovascular mortality were independent of major confounders and strongest for highest values of the heart valve sclerosis score. AVS-related mortality was more pronounced in women than in men. Conclusion: AVS and MAC are associated with all-cause and cardiovascular mortality. The association between AVS and mortality is gender-specific with women with AVS being at a higher mortality risk than men with AVS. The summation of AVS and MAC to a heart valve sclerosis score improves the predictability with respect to mortality.

Original languageEnglish
Pages (from-to)606-610
Number of pages5
Issue number2
Publication statusPublished - 1 Apr 2010
Externally publishedYes


  • Aortic valve sclerosis
  • Atherosclerosis
  • Epidemiology
  • Mitral annulus calcification
  • Mortality

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