Valvular & structural heart disease
Aortic Valve Calcification Density Measured by MDCT in the Assessment of Aortic Stenosis Severity
Authors' conclusion
AVCdCT appears to be equivalent or superior to AVC and AVCdEcho to assess AS severity and predict all-cause mortality.
Study context
- Population
- Patients, mainly White, with calcific aortic stenosis (AS) who underwent Doppler echocardiography and multidetector CT within the same episode of care
- Participants
- 889 patients
- Exposure
- AVCdCT vs aortic valve calcification (AVC) vs AVCdEcho
- Outcome
- All-cause mortality
- Follow-up
- Median 6.62 (6.19-9.69) years
Main finding
As reported in the abstract
All-cause mortality prediction (multivariate)
Hazard ratio (95% CI)P value
AVCdCTAVCdCT ratio
1.59(1.26–2.00)
P < 0.001AVCAVC ratio
1.53(1.11–1.65)
P = 0.003AVCdEchoAVCdEcho ratio
1.27(1.11–1.46)
P < 0.001- AVCdCT ratio superior to AVC ratio and AVCdEcho ratio
- all likelihood test P≤0.004
Observational data: associations, not effects.
Further findings
Survival under medical treatment (multivariate)
| HR (95% CI) | P value | ||
|---|---|---|---|
| AVCdCTAVCdCT ratio | 1.80 (1.27–1.58) | P < 0.001 | |
| AVCAVC ratio | 1.55 (1.13–2.10) | P = 0.007 | |
| AVCdEchoAVCdEcho ratio | 1.28 (1.03–1.57) | P = 0.01 | |
| 0.512Hazard ratio (log scale) |
| Outcome | AVCdCT | AVC | AVCdEcho |
|---|---|---|---|
| Correlation of AVCd with gradient/velocity | |||
| R (gradient) | 0.68 | 0.61 | 0.61 |
| R (velocity) | 0.66 | 0.60 | 0.59 |
- Correlation of AVCd with gradient/velocity — Correlations stronger with AVCdCT
- both P≤0.005
- Survival under medical treatment (multivariate) — AVCdCT ratio superior
- all likelihood test P<0.03
- Correlation of AVCd with gradient/velocity: all individual correlations P<0.001
AVCdCT thresholds for severe AS (ROC)
Agatston units (AU)/cm²
- Women
- 334
- Men
- 467
Mortality by subgroup
- AVCdCT ratio predicts mortality in all subgroups
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Aortic Valve Calcification Density Measured by MDCT in the Assessment of Aortic Stenosis Severity. Circ Cardiovasc Imaging. Published 21 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →