O44-5 - Association between Nonobstructive Aortic Valve Calcification and Left Ventricular Diastolic Dysfunction in Patients with Preserved Ejection Fraction

Abstract

Background: The impact of aortic valve calcification (AVC) itself on cardiac structure and function remains unknown. Methods: We studied 621 patients with nonobstructive AVC (transaortic velocity <2.5 m/s) but normal ejection fraction. Early diastolic myocardial velocities at the mitral annulus (Ea) were obtained. Left ventricular (LV) concentric hypertrophy was defined as LVMI >47 g/m2.7 in women and >49 g/m2.7 in men and relative wall thickness >0.43. CT scans were also performed to measure the AVCand coronary artery calcification (CAC) scores and the visceral adipose tissue (VAT) area. Results: Patients with AVC had a higher LVMI (42 ± 10 vs. 38 ± 10 g/m2.7, P < .001) and LV mass/volume ratio (1.73 ± 0.64 vs. 1.51 ± 0.53 g/ml, P < .001), and had a higher prevalence of LV concentric hypertrophy (11.5 vs. 5.4%, P = .008) compared to no AVC group. After adjustment for demographic variables and other confounding factors including CAC score and VAT area, log-transformed AVC score was independently associated with septal and lateral Ea. Interestingly, despite further adjustment for LV mass/volume ratio, AVC score remained as an independent predictor for septal Ea (β-estimate [95%CI] −0.256 [−0.408 to −0.105], P = .001) and lateral Ea (−0.259 [−0.497 to −0.021], P = .033). Conclusion: AVC was independently associated with LV diastolic dysfunction even in patients with nonobstructive AVC. In addition to LV hypertrophy, other mechanism may lie between valve calcification and diastolic dysfunction.