The association of incidentally detected heart valve calcification with future cardiovascular eventsReport as inadecuate




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European Radiology

, Volume 21, Issue 5, pp 963–973

First Online: 08 November 2010Received: 09 June 2010Revised: 23 September 2010Accepted: 25 September 2010

Abstract

ObjectivesThis 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.

MethodsThe 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.

Results515 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.

ConclusionIncidental 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.

KeywordsSurvival analysis Heart valves Thorax Cardiovascular diseases Computed tomography AbbreviationsAVCAortic Valve Calcification

AVLAortic Valve Leaflet

CHDCoronary Heart Disease

CIConfidence Interval

CTComputed Tomography

CVDCardiovascular Disease

FOVField of View

MACMitral Annular Calcification

MVCMitral Valve Calcification

MVLMitral Valve Leaflet

PAODPeripheral Arterial Obstructive Disease

PROVIDIPrognostic Value of Unrequested Information in Diagnostic Imaging

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Author: Martijn J. A. Gondrie - Yolanda van der Graaf - Peter C. Jacobs - Ay L. Oen - Willem P. Th. M. Mali - On behalf of th

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