Author + information
- Admir Dedic,
- Gert–Jan ten Kate,
- Lisan Neefjes,
- Koen Nieman,
- Gabriel Krestin,
- Eric Sijbrands,
- Pim de Feyter and
- MC Erasmus
To evaluate the influence of LDL receptor (LDLR) –negative mutational status on aortic valve calcification (AoVC) using cardiac CT in asymptomatic statin treated patients with a clinical diagnosis of familial hypercholesterolemia (FH).
Cardiac CT was performed in 145 FH patients (93 men; mean age 52 ± 8) screened for LDLR, apolipoprotein B and proprotein convertase subtilisin/kexin type 9 mutations. AoVC was compared between two groups: 1) 59 patients (41%) heterozygous for LDLR–negative mutations and 2) 86 patients (59%) with reduced or normal LDLR function (LDLR–positive): 32 LDLR–defective mutations, 8 apolipoprotein B mutations and 46 patients in whom no mutation could be identified. The AoVC score was expressed as the volume of the aortic valve calcification. As a secondary endpoint we evaluated the association between the presence of AoVC and CT atherosclerosis: coronary artery disease (CAD), coronary calcium (CC) and aortic root calcification (AoRC).
In LDLR–negative mutational FH the prevalence of AoVC (51%) and the AoVC score 0 (0–59) were higher than in LDLR–positive FH (33% and 0 (0–7) (P=0.027 and P=0.019). After adjustment for risk factors, LDLR–negative mutational FH remained an independent predictor of the AoVC score (P=0.022). Patients had higher amounts of CAD, CC and AoRC if AoVC was present both in LDLR–negative and LDLR–positive mutational FH (P ≤ 0.008 for all comparisons).
Statin treated FH patients with LDLR–negative mutations have higher amounts of AoVC confirming the critical role of LDL metabolism for the etiology of AoVC. The presence of AoVC is intimately associated with CT atherosclerosis suggesting related pathophysiological determinants.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Valvular Heart Disease: Clinical IV – Aortic Valve Disease
Abstract Category: 31. Valvular Heart Disease: Clinical
Presentation Number: 1197M–81
- 2013 American College of Cardiology Foundation