Valvular & structural heart diseaseDiagnostic or prognostic study
Quantitative Computed Tomography Angiography for the Evaluation of Valvular Fibrocalcific Volume in Aortic Stenosis
- Imaging validation and prognostic cohort study
- external validation cohort
- histology validation
- scan-rescan reproducibility
Authors' conclusion
The aortic valve fibrocalcific volume provides an anatomic assessment of AS severity that can track disease progression precisely. It correlates with disease severity and hemodynamic progression in both male and female patients.
Study context
- Population
- Patients with aortic stenosis (AS) undergoing computed tomography (CT) angiography at baseline and after 1 yearexternal cohort n = 66
- Participants
- 136 patients
- Outcome
- Aortic valve fibrocalcific volume by CT angiography: reproducibility, association with histology and disease severity, prediction/tracking of progression
Performance
As reported in the abstract
- Measurement time
- 5.8 ± 1.0 min/scan
- Correlation with ex vivo valve weight
- r = 0.51; P < 0.001
- Scan-rescan reproducibility: mean difference (limits of agreement −4.5% to 2.8%)
- −1%
- Correlation with echo mean gradient, male participants
- rho = 0.64; P < 0.001
- Correlation with echo mean gradient, female participants
- rho = 0.69; P < 0.001
- Correlation with mean gradient, external validation cohort (n = 66)
- rho = 0.58; P < 0.001
- Increase in fibrocalcific volume after 1 year
- 17%
- Correlation of fibrocalcific volume change with mean gradient progression
- rho = 0.32; P = 0.003
- Baseline fibrocalcific volume as predictor of mean gradient progression, female patients (strongest predictor)
- rho = 0.75; P < 0.001
Further findings
Driver of fibrocalcific volume–mean gradient relationship
- Driven principally by calcific volume in men and fibrotic volume in women
Original publication
Quantitative Computed Tomography Angiography for the Evaluation of Valvular Fibrocalcific Volume in Aortic Stenosis. JACC Cardiovasc Imaging. Published 7 August 2024. doi:10.1016/j.jcmg.2024.06.007
Summarised from the published abstract; every number is checked against it