Valvular & structural heart disease
Aortic Valve Calcium Score Quantification by Contrast Cardiac Computed Tomography (CT): Correlations With Echocardiography and Optimal Thresholds
Authors' conclusion
AVCa by contrast CT is a useful tool for identifying severe AS by TTE, with sex-specific thresholds for severe AS identified. Further studies are necessary to externally validate our findings and evaluate their prognostic significance.
Study context
- Population
- Patients with native aortic stenosis (AS) undergoing transcatheter aortic valve replacement evaluation from 2019 to 2020 who underwent TTE and contrast-enhanced CTage 79±9 years, 429 (41.5%) women, 906 (87.5%) severe and 129 (12.5%) moderate AS by TTE
- Participants
- 1,035 patients
- Comparison
- AVCa measured on contrast CT against transthoracic echocardiography (TTE) measures of AS
- Outcome
- Aortic valve area on TTE and AVCa score, volume, mass
Methodological detailsderivation cohort and validation cohort
- Derivation cohort and validation cohort
Performance
As reported in the abstract
Mean aortic valve area on TTE
0.79±0.21 cm 2
Mean AVCa score
2152±1102 modified AU
Mean AVCa volume
1853±1592 mm 3
Mean AVCa mass
673±485 mg
Further findings
| Outcome | Men, derivation cohort (≥1840 modified AU) | Women, derivation cohort (≥1430 modified AU) | Men, validation cohort | Women, validation cohort |
|---|---|---|---|---|
| Optimal AVCa thresholds for severe AS by TTEReceiver-operating characteristics analysis and Youden index | ||||
| AUC (95% CI) | 0.809 (0.749-0.869 | 0.822 (0.751-0.892) | 0.830 (0.786-0.875) | 0.780 (0.670-0.890) |
| Sensitivity | 71.3% | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract |
| Specificity | 82.2% | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract |
| Sensitivity/specificity | — not stated in the abstract | 73.4%/78.9% | 75.9%/87.5% | 77.5%/71.4% |
— not stated in the abstract
- Optimal AVCa thresholds for severe AS by TTE — Optimal severe AS threshold, men
- ≥1840 modified AU
- Optimal AVCa thresholds for severe AS by TTE — Optimal severe AS threshold, women
- ≥1430 modified AU
Factors associated with AVCa (multivariable linear regression)
- Women associated with lower AVCa (β-coefficient)
- −358
- Chronic kidney disease associated with higher AVCa (β-coefficient)
- 171
Original publication
Aortic Valve Calcium Score Quantification by Contrast Cardiac CT: Correlations With Echocardiography and Optimal Thresholds. Circ Cardiovasc Imaging. Published 16 May 2025. doi:10.
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