Increasing baseline aortic valve peak flow velocity is associated with progression of aortic valve stenosis in osteoporosis patients-a possible link to low vitamin D status

Toshihiro Tsuruda; Taro Funamoto; Chiyoko Suzuki; Yoshimasa Yamamura; Michikazu Nakai; Etsuo Chosa; Koichi Kaikita

doi:10.1007/s11657-023-01339-2

Increasing baseline aortic valve peak flow velocity is associated with progression of aortic valve stenosis in osteoporosis patients-a possible link to low vitamin D status

Arch Osteoporos. 2023 Oct 24;18(1):129. doi: 10.1007/s11657-023-01339-2.

Authors

Toshihiro Tsuruda^{1

2}, Taro Funamoto³, Chiyoko Suzuki⁴, Yoshimasa Yamamura⁵, Michikazu Nakai⁶, Etsuo Chosa³, Koichi Kaikita⁵

Affiliations

¹ Cardiorenal Research Laboratory, Department of Vascular Advanced Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. ttsuruda@med.miyazaki-u.ac.jp.
² Division of Internal Medicine, Cardiovascular Medicine and Nephrology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. ttsuruda@med.miyazaki-u.ac.jp.
³ Division of Orthopaedic Surgery, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
⁴ Clinical Laboratory, University of Miyazaki Hospital, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
⁵ Division of Internal Medicine, Cardiovascular Medicine and Nephrology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
⁶ Clinical Research Support Center, University of Miyazaki Hospital, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.

Abstract

Purpose: The purpose of this study was to investigate the morphological characteristics of the aortic valve and identify factors associated with the progression of aortic valve stenosis (AS) in osteoporosis patients.

Methods: In this single-center prospective cohort study, we recruited 10 patients (mean age: 75 ± 7 years, 90% female) who were taking anti-resorptive medicines at the outpatient clinic of University of Miyazaki Hospital, Japan. Baseline assessments, including transthoracic echocardiogram, blood sampling, and dual energy X-ray absorptiometry, were performed. Follow-up assessments were conducted at 6, 12, 18, and 24 months.

Results: During the 2-year follow-up, three patients with aortic valve peak flow velocity (AV PFV) ≥2 m/s at baseline developed moderate AS, which is defined as AV PFV ≥3 m/s. However, seven patients with AV PFV <2 m/s did not exhibit any progression of AS. There were significant variations in terms of bone mineral density, T-score values, and biomarkers associated with bone turnover (i.e., bone alkaline phosphatase, tartrate-resistance acid phosphatase-5b) among the enrolled patients, but none of these factors were found to be associated with the progression of AS. All patients exhibited low vitamin D status, with a median level of 16.1 ng/mL (25^th percentile, 9.7 ng/mL; 75^th percentile, 23 ng/mL). The baseline levels of AV PFV values were negatively correlated with 25-hydroxyvitamin D levels, determined by univariate linear regression analysis (beta coefficient = -0.756, 95% confidence interval, -0.136 ̶ -0.023, p = 0.011).

Conclusion: Our data suggest that low vitamin D status might be a potential risk factor for the progression of AS in osteoporosis patients undergoing treatment with anti-resorptive medicines. Elderly patients with osteoporosis patients exhibited a subset of aortic valve stenosis. Our data suggest that the baseline aortic valve peak flow velocity predicts the progression of aortic valve stenosis, and there might be an association between the progression and the co-existing low vitamin D status in these patients.

Keywords: Calcium; Echocardiogram; Osteoporosis; Valvular disease; Vitamin D.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Aortic Valve / diagnostic imaging
Aortic Valve Stenosis* / diagnostic imaging
Female
Humans
Male
Osteoporosis* / complications
Osteoporosis* / diagnostic imaging
Prospective Studies
Vitamin D

Substances

Vitamin D