The influence of severe bone loss on mitral annular calcification in postmenopausal osteoporosis of elderly Japanese women.

Abstract

We assessed the influence of aging bone calcium metabolism on mitral annular calcification (MAC) and aortic valve calcification (AVC) in 239 septua- and octogenarians (62 men, 177 women; 80.2 +/- 4.4 years). Osteoporosis was diagnosed by vertebral bone fracture. Both MAC and AVC were derived by 2-dimensional echocardiography. Bone mineral content (BMC) of the lumbar vertebral body was obtained by single-energy quantitative computed tomography using a calibration phantom. Serum calcium, phosphorus, parathyroid hormone, calcitonin, and osteocalcin were examined. Patients were classified into 3 age-matched groups in each sex: Group-C included patients with MAC (-) and AVC (-) (n = 96); Group-A was those with AVC (+) and MAC (-) (n = 80); Group-M consisted of those with MAC (+) and AVC (-) or AVC (+) (n = 63). Osteoporosis-frequency and BMC in women were significantly higher (p < 0.01) and lower (p < 0.001) respectively than those in men. Among men, osteoporosis-frequency and BMC showed no difference between the 3 groups. Among women, osteoporosis-frequency (52%) and BMC (32 +/- 23 mg/cm3) in Group-M were higher (NS) and significantly less (p < 0.01) than those (37%, 49 +/- 36) in Group-C, respectively. In both sexes, serum examinations revealed no differences between the 3 groups. These results suggest that: 1) MAC in elderly women can be attributed to ectopic calcium deposits, related to the severe bone loss caused by postmenopausal osteoporosis; 2) there is no significant relationship between the incidence of MAC or AVC and the humoral factors of calcium metabolism; and 3) AVC may be mainly caused by pressure or stress loading.