Abstract
The role of medical therapy to treat calcification in the cardiovascular system is under intense investigation. Large cohort databases have provided significant data regarding risk factors, and timing of calcification progression. However, there is no proven medical therapy to slow the progression of disease. The Go No Theory provides the foundation for potential for medical therapy, by initiating treatments early in subclinical disease for longer periods of time. This chapter will discuss the hemodynamic effects on the expression of an osteocardiac phenotype in the heart and the potential for future medical therapy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rajamannan NM, Evans FJ, Aikawa E, et al. Calcific aortic valve disease: not simply a degenerative process: a review and agenda for research from the National Heart and Lung and Blood Institute Aortic Stenosis Working Group. Executive summary: calcific aortic valve disease-2011 update. Circulation. 2011;124:1783–91.
FHS. Framingham Heart Study Website. 2017. http://wwwframinghamheartstudyorg. Accessed 2 March 2017.
Deutscher S, Rockette HE, Krishnaswami V. Diabetes and hypercholesterolemia among patients with calcific aortic stenosis. J Chronic Dis. 1984;37:407–15.
Hoagland PM, Cook EF, Flatley M, Walker C, Goldman L. Case-control analysis of risk factors for presence of aortic stenosis in adults (age 50 years or older). Am J Cardiol. 1985;55:744–7.
Aronow WS, Ahn C, Kronzon I, Goldman ME. Association of coronary risk factors and use of statins with progression of mild valvular aortic stenosis in older persons. Am J Cardiol. 2001;88:693–5.
Mohler ER, Sheridan MJ, Nichols R, Harvey WP, Waller BF. Development and progression of aortic valve stenosis: atherosclerosis risk factors—a causal relationship? A clinical morphologic study. Clin Cardiol. 1991;14:995–9.
Lindroos M, Kupari M, Valvanne J, Strandberg T, Heikkila J, Tilvis R. Factors associated with calcific aortic valve degeneration in the elderly. Eur Heart J. 1994;15:865–70.
Boon A, Cheriex E, Lodder J, Kessels F. Cardiac valve calcification: characteristics of patients with calcification of the mitral annulus or aortic valve. Heart. 1997;78:472–4.
Chui MC, Newby DE, Panarelli M, Bloomfield P, Boon NA. Association between calcific aortic stenosis and hypercholesterolemia: is there a need for a randomized controlled trial of cholesterol-lowering therapy? Clin Cardiol. 2001;24:52–5.
Wilmshurst PT, Stevenson RN, Griffiths H, Lord JR. A case-control investigation of the relation between hyperlipidaemia and calcific aortic valve stenosis. Heart. 1997;78:475–9.
Chan KL, Ghani M, Woodend K, Burwash IG. Case-controlled study to assess risk factors for aortic stenosis in congenitally bicuspid aortic valve. Am J Cardiol. 2001;88:690–3.
Briand M, Lemieux I, Dumesnil JG, et al. Metabolic syndrome negatively influences disease progression and prognosis in aortic stenosis. J Am Coll Cardiol. 2006;47:2229–36.
Palta S, Pai AM, Gill KS, Pai RG. New insights into the progression of aortic stenosis: implications for secondary prevention. Circulation. 2000;101:2497–502.
Peltier M, Trojette F, Sarano ME, Grigioni F, Slama MA, Tribouilloy CM. Relation between cardiovascular risk factors and nonrheumatic severe calcific aortic stenosis among patients with a three-cuspid aortic valve. Am J Cardiol. 2003;91:97–9.
Stewart BF, Siscovick D, Lind BK, et al. Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study. J Am Coll Cardiol. 1997;29:630–4.
Pohle K, Maffert R, Ropers D, et al. Progression of aortic valve calcification: association with coronary atherosclerosis and cardiovascular risk factors. Circulation. 2001;104:1927–32.
Messika-Zeitoun D, Aubry MC, Detaint D, et al. Evaluation and clinical implications of aortic valve calcification measured by electron-beam computed tomography. Circulation. 2004;110:356–62.
Bild DE, Detrano R, Peterson D, et al. Ethnic differences in coronary calcification: the multi-ethnic study of atherosclerosis (MESA). Circulation. 2005;111:1313–20.
Lazaros G, Toutouzas K, Drakopoulou M, Boudoulas H, Stefanadis C, Rajamannan N. Aortic sclerosis and mitral annulus calcification: a window to vascular atherosclerosis? Expert Rev Cardiovasc Ther. 2013;11:863–77.
Cao J, Steffen BT, Budoff M, et al. Lipoprotein(a) levels are associated with subclinical calcific aortic valve disease in White and Black individuals: the multi-ethnic study of atherosclerosis. Arterioscler Thromb Vasc Biol. 2016;36:1003–9.
Ten Kate GJ, Neefjes LA, Dedic A, et al. The effect of LDLR-negative genotype on CT coronary atherosclerosis in asymptomatic statin treated patients with heterozygous familial hypercholesterolemia. Atherosclerosis. 2013;227:334–41.
Awan Z, Alrasadi K, Francis GA, et al. Vascular calcifications in homozygote familial hypercholesterolemia. Arterioscler Thromb Vasc Biol. 2008;28:777–85.
Hamirani YS, Nasir K, Blumenthal RS, et al. Relation of mitral annular calcium and coronary calcium (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol. 2011;107:1291–4.
Thanassoulis G, Campbell CY, Owens DS, et al. Genetic associations with valvular calcification and aortic stenosis. N Engl J Med. 2013;368:503–12.
Figueiredo CP, Rajamannan NM, Lopes JB, et al. Serum phosphate and hip bone mineral density as additional factors for high vascular calcification scores in a community-dwelling: the Sao Paulo Ageing & Health Study (SPAH). Bone. 2013;52:354–9.
Rajamannan NM. Atorvastatin attenuates bone loss and aortic valve atheroma in LDLR mice. Cardiology. 2015;132:11–5.
Rajamannan NM, Edwards WD, Spelsberg TC. Hypercholesterolemic aortic-valve disease. N Engl J Med. 2003;349:717–8.
Rajamannan NM. Mechanisms of aortic valve calcification: the LDL-density-radius theory A: translation from cell signaling to physiology. Am J Physiol. 2010;298:H5–15.
Nissen SE, Tuzcu EM, Schoenhagen P, et al. Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. JAMA. 2004;291:1071–80.
Hatle L, Angelsen BA, Tromsdal A. Non-invasive assessment of aortic stenosis by Doppler ultrasound. Br Heart J. 1980;43:284–92.
Smith MD, Kwan OL, DeMaria AN. Value and limitations of continuous-wave Doppler echocardiography in estimating severity of valvular stenosis. JAMA. 1986;255:3145–51.
Hatle L, Brubakk A, Tromsdal A, Angelsen B. Noninvasive assessment of pressure drop in mitral stenosis by Doppler ultrasound. Br Heart J. 1978;40:131–40.
Tonino PA, De Bruyne B, Pijls NH, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009;360:213–24.
Rajamannan NM. Calcific aortic valve disease in familial hypercholesterolemia: the LDL-density-gene effect. J Am Coll Cardiol. 2015;66:2696–8.
Bernoulli D. Hydrodynamica sive de viribus et motibus fluidorum commentarrii. Strasbourg: Argentoratum; 1738. p. St31.
Gerdts E, Rossebo AB, Pedersen TR, et al. Impact of baseline severity of aortic valve stenosis on effect of intensive lipid lowering therapy (from the SEAS study). Am J Cardiol. 2010;106:1634–9.
Cowell SJ, Newby DE, Burton J, et al. Aortic valve calcification on computed tomography predicts the severity of aortic stenosis. Clin Radiol. 2003;58:712–6.
Chan KL, Teo K, Dumesnil JG, Ni A, Tam J, Investigators A. Effect of Lipid lowering with rosuvastatin on progression of aortic stenosis: results of the aortic stenosis progression observation: measuring effects of rosuvastatin (ASTRONOMER) trial. Circulation. 2010;121:306–14.
McClelland RL, Jorgensen NW, Budoff M, et al. 10-year coronary heart disease risk prediction using coronary artery calcium and traditional risk factors: derivation in the MESA (Multi-Ethnic Study of Atherosclerosis) with validation in the HNR (Heinz Nixdorf Recall) study and the DHS (Dallas Heart Study). J Am Coll Cardiol. 2015;66:1643–53.
Owens DS, Katz R, Takasu J, Kronmal R, Budoff MJ, O’Brien KD. Incidence and progression of aortic valve calcium in the multi-ethnic study of atherosclerosis (MESA). Am J Cardiol. 2010;105:701–8.
Owens DS, Budoff MJ, Katz R, et al. Aortic valve calcium independently predicts coronary and cardiovascular events in a primary prevention population. JACC Cardiovasc Imaging. 2012;5:619–25.
Budoff MJ, Nasir K, Katz R, et al. Thoracic aortic calcification and coronary heart disease events: the multi-ethnic study of atherosclerosis (MESA). Atherosclerosis. 2011;215:196–202.
Hyder JA, Allison MA, Wong N, et al. Association of coronary artery and aortic calcium with lumbar bone density: the MESA Abdominal Aortic Calcium Study. Am J Epidemiol. 2009;169:186–94.
Rajamannan N. Wnt signaling in atherosclerosis: the Go/No Go theory for clinical trials in osteocardiology. Cardiology. 2017. (in press).
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Rajamannan, N.M. (2018). Osteocardiology: The Go/No Go Theory for Clinical Trials. In: Osteocardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-64994-8_10
Download citation
DOI: https://doi.org/10.1007/978-3-319-64994-8_10
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-64993-1
Online ISBN: 978-3-319-64994-8
eBook Packages: MedicineMedicine (R0)