Valvular & structural heart diseaseCross-sectional study
Differential roles of calcification and fibrosis in aortic stenosis: a sex- and morphology-specific CT analysis
- cross-sectional analysis
Authors' conclusion
Valvular calcification is the tissue component more strongly and consistently associated with disease severity in AS, irrespective of whether assessed by peak aortic jet velocity or indexed AVA. Fibrosis represents a distinct phenotypic feature, particularly prominent in women with BAV.
Study context
- Population
- Aortic stenosis (AS) patients with preserved flow (left ventricular ejection fraction ≥50%, stroke volume index >35 mL/m²) who underwent comprehensive echocardiography and cardiac CTAS patients enrolled
- Participants
- 448 patients
- Exposure
- stratified by sex and valve morphology [bicuspid (BAV) or tricuspid (TAV) aortic valve]
Main finding
As reported in the abstract
Calcificvolumedensity vs peak aortic jet velocity R
R = 0.571, P < 0.001
indexed aortic valve area (AVA) R
R = −0.466, P < 0.001
Observational data: associations, not effects.
Further findings
Correlation of fibrotic volume density with severity
- minimal or non-significant correlations with severity indices and lacked a proportional association across severity stages
Severe AS, BAV: women vs men
- women with BAV had higher fibrotic volume density than men (by peak aortic jet velocity and indexed AVA)
- P = 0.017 and 0.062
- men exhibited greater calcification
- Both P < 0.001
TAV: men vs women
- men had higher calcific volume density
- Both P < 0.001
- similar fibrotic volume density
- P = 0.792 and 0.923
Baseline characteristics
- Mean age
- 64.6 ± 10.1 years
- female
- 48.2%
- BAV
- 54.5%
Original publication
Summarised from the published abstract; every number is checked against it