Association of mitral annulus calcification, aortic valve sclerosis and aortic root calcification with abnormal myocardial perfusion single photon emission tomography in subjects age <= 65 years old

OBJECTIVES We examined the hypothesis that mitral annulus calcification (MA C), aortic valve sclerosis (AVS) and aortic root calcification (ARC) are as sociated with coronary artery disease (CAD) in subjects age less than or eq ual to 65 years. BACKGROUND Mitral annulus calcification, AVS and ARC frequently coexist and arc associated with coronary risk factors and CAD in the elderly. METHODS We studied 338 subjects age less than or equal to 65 years who unde rwent evaluation of chest pain with myocardial perfusion single photon emis sion computed tomography (SPECT) and a two-dimensional transthoracic echoca rdiogram for other indications. The association of MAC, AVS and ARC with ab normal SPECT was evaluated by using chi-square analyses and logistic regres sion analyses. RESULTS Compared with no or one calcium deposit and no or one coronary risk factor other than diabetes, multiple (greater than or equal to2) calcium ( or sclerosis) deposits with diabetes or multiple (greater than or equal to2 ) coronary risk factors were significantly associated with abnormal SPECT i n women age less than or equal to 55 years old (odds ratio [OR], 20.00), in women age >55 years old (OR, 10,00) and in men age less than or equal to 5 5 years old (OR, 5.55). Multivariate analyses identified multiple calcium d eposits as a significant predictor for an abnormal SPECT in women (p < 0.00 1), younger subjects age <less than or equal to>55 years (p < 0.05) and the total group of subjects (p < 0.01). CONCLUSIONS When coronary risk factors are also taken into consideration, t he presence of multiple calcium deposits in the mitral annulus, aortic valv e or aortic root appears to be a marker of CAD in men less than or equal to 55 years old and women. (J Am Coll Cardiol 2001;38:1988-93) (C) 2001 by th e American College of Cardiology.