Valvular & structural heart diseaseCohort study
Planimetry of Aortic Valve Area Using CTA: Cutoff Derivation for Stenotic Bicuspid and Tricuspid Valves
- retrospective single-center analysis
- computed tomography angiography data from 2013 to 2025
- internally validated
Authors' conclusion
Direct planimetry of AVA is feasible and shows utility in low gradient-aortic stenosis. However, as the hemodynamic effect is impacted by valve shape, cutoff values should differentiate between tricuspid and bicuspid valves.
Study context
- Population
- Patients with aortic stenosis (tricuspid and bicuspid valves) with computed tomography angiography dataTTE-based conclusive severe or nonsevere patients (derivation) · derivation 1,294 · internal validation 480 · normal-flow low-gradient aortic stenosis cases 190
- Participants
- 1,294 patients
- Exposure
- aAVA CTA against effective AVA by TTE; cutoffs compared with the Agatston score by net reclassification index
Main finding
As reported in the abstract
Correlation between aAVA CTA and effective AVA by TTE
tricuspid valves
0.67
Pearson r
bicuspid valves
0.78
Pearson r
Observational data: associations, not effects.
Further findings
Severe stenosis cutoffs, tricuspid valves
- likely at aAVA CTA
- ≤0.95 cm²
- sensitivity
- 87%
- specificity
- 78.9%
- unlikely at
- ≥1.10 cm²
- negative likelihood ratio
- 0.092
Severe stenosis cutoffs, bicuspid valves
- likely at aAVA CTA
- ≤1.08 cm²
- sensitivity
- 88.3%
- specificity
- 77.3%
- unlikely at
- ≥1.20cm 2
- negative likelihood ratio
- 0.091
Validation
- Validation showed comparable results
Net reclassification index compared with the Agatston score
- likely cutoffs
- 0.16
- unlikely cutoffs
- 0.17
- P <0.001
Reclassification to nonsevere in suspected severe low-gradient cases
- reclassified to nonsevere
- 5.8%
- 190 suspected severe low-gradient cases
Original publication
Planimetry of Aortic Valve Area Using CTA: Cutoff Derivation for Stenotic Bicuspid and Tricuspid Valves. Circ Cardiovasc Imaging. Published 22 January 2026. doi:10.1161/circimaging.125.018677
Summarised from the published abstract; every number is checked against it