Veertig jaar epidemiologie aan de Erasmus Universiteit 1969-2009

Waarschijnlijk telt geen land ter wereld per hoofd van de bevolking zoveel epidemiologen als Nederland. De Nederlandse Vereniging van Epidemiologen is een van de grootste in Europa. Elke maand verschijnen in de beste internationale wetenschappelijke tijdschriften resultaten van Nederlands epidemiologisch onderzoek. En het zijn artikelen die ertoe doen. In de top 25 van meest geciteerde Nederlands onderzoekers zijn er alleen al zes gelieerd aan het ERGO-onderzoek: een cohort van inmiddels ruim 15.000 Rotterdammers dat nu al bijna 20 jaar loopt. Om kort te gaan: epidemiologie is hot in Holland. Deze bundel bevat afscheidsredes en oraties uit de afgelopen veertig jaar, Tot slot bevat dit boek een opsomming van promovendi die vanuit de afdeling Epidemiologie hun proefschrift verdedigden aan de Erasmus Universiteit, en van alle medewerkers, oud-medewerkers en gasten met een formele aanstelling bij de afdeling Epidemiologie

Relationship between incidentally detected calcification of the mitral valve on 64-row multidetector computed tomography and mitral valve disease on echocardiography

Mehrnoush Toufan,1 Reza Javadrashid,2 Neda Paak,2 Morteza Gojazadeh,3 Majid Khalili41Cardiovascular Research Center, 2Department of Radiology, 3Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 4Azerbaijan National Academy of Sciences, Baku, AzerbaijanBackground: Mitral valve calcification is often incidentally detected on chest computed tomography (CT) scans obtained for a variety of noncardiac indications. In this study, we evaluated the association between mitral valve calcification incidentally detected on chest CT and the presence and severity of mitral valve disease on echocardiography.Methods: Of 760 patients undergoing 64-row multidetector CT of the chest, 50 with mitral valve calcification and 100 controls were referred on for echocardiography. Calcifications of the mitral valve leaflet and annulus were assessed for length, Agatston score, and site, and were compared with echocardiographic findings.Results: Mitral valve calcification was noted in 59 (7.7%) patients on multidetector CT. Fifty of these patients were assessed by echocardiography, and 32 (64%) were found to have mitral annular calcification. Nine patients (18%) had posterior mitral valve leaflet calcification, and both mitral valve leaflet and annular calcification were detected in nine (18%) cases. Nine (18%) patients had mild, three (6%) had moderate, and one (2%) had severe mitral stenosis. None of the patients with isolated mitral annular calcification had mitral stenosis; however, all the patients with mitral stenosis showed mitral valve leaflet calcification with or without mitral annular calcification (P < 0.001). Moreover, patients with mitral stenosis had a larger mitral calcification length and greater Agatston scores in comparison with those without mitral stenosis (P = 0.001). While 31 patients (62%) with mitral calcification had mitral regurgitation on echocardiography, 21 (21%) in the control group showed mitral regurgitation (P = 0.001).Conclusion: Mitral valve leaflet calcification, with or without annular calcification, may be an indicator of mitral stenosis. Mitral calcification can also be considered as an indicator for mitral regurgitation in general. Therefore, patients with mitral valve calcification detected incidentally on chest CT scan may benefit from functional assessment of the valve using echocardiography.Keywords: mitral annular calcification, mitral valve leaflet calcification, multidetector computed tomography, mitral regurgitation, mitral stenosi