Valvular & structural heart disease
Usefulness of Aortic Valve Calcification in Patients With Low-Flow Aortic Stenosis
Authors' conclusion
In patients with CLF-AS or PLF-AS, AVC is a major predictor of mortality. Thus, AVC should be used in low-flow patients to assess AS severity and stratify risk. Importantly, in patients with reduced left ventricular ejection fraction, a nonsevere AS (ie, AVC 70% of severe) could be associated with reduced survival.
Study context
- Population
- Patients with classical low-flow (low-flow reduced left ventricular ejection fraction) or paradoxical low-flow (low-flow preserved left ventricular ejection fraction) aortic stenosis who underwent Doppler echocardiography and multidetector computed tomographypatients prospectively included · CLF-AS 319 (49.8%) · PLF-AS 322 (50.2%)
- Participants
- 641 patients
- Exposure
- Predictive value of aortic valve calcification (AVC) for all-cause mortality
- CLF-ASn = 319
- PLF-ASn = 322
- Outcome
- All-cause mortality regardless of treatment
- Follow-up
- Median 4.9 (4.3-5.9) years
Main finding
As reported in the abstract
Adjusted hazard ratio (95% CI)P value
AVCratio (CLF-AS)
1.25(1.01–1.56)
P = 0.046AVCratio (PLF-AS)
1.51(1.14–2.00)
P = 0.004- Deaths
- 265
Observational data: associations, not effects.
Further findings
AVC ratio (AVCratio) ≥
| Outcome | CLF-AS | PLF-AS |
|---|---|---|
| Best AVCratio threshold to predict mortality | 0.7 | 1 |
Identification of AS severity by sex-specific AVC thresholds
- AS severity identified correctly
- 137 (87%)
AVCratio as a dichotomic variable and all-cause mortality
- Associated with all-cause mortality in all groups
- P ≤ 0.001
- After a comprehensive analysis
Addition of AVCratio to the models
- Improved all models' predictive value, all net reclassification index
- >18%
- All P
- ≤0.05
Original publication
Usefulness of Aortic Valve Calcification in Patients With Low-Flow Aortic Stenosis. Circ Cardiovasc Imaging. Published 8 January 2025. doi:10.
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