Indexed Aortic Valve Calcium Volume by Computed Tomography Angiography in Patients With Aortic Stenosis
Year: 2025
Type: paratext
Abstract: BackgroundCalcium scoring from noncontrast computed tomography (CT) is used clinically to adjudicate aortic stenosis severity in patients with discordant echocardiography. ObjectivesThe aim of this study was to investigate whether quantification of aortic valve calcium volume from computed tomography angiography (CTA) can provide robust diagnostic discrimination of disease severity and inform risk stratification of patients with aortic stenosis. MethodsPatients with mild to severe aortic stenosis who underwent concurrent CTA and echocardiography were included in a retrospective international multicenter observational cohort study. Accuracy of aortic valve calcium volume to diagnose severe aortic stenosis in patients with concordant disease on echocardiography was assessed. Association of aortic valve calcium volume with the incidence of aortic valve replacement or all-cause death was investigated. ResultsThe study included 1,521 patients (mean age: 74 ± 10 years; 44% female; median peak aortic jet velocity: 3.8 m/s [Q1-Q3: 3.1-4.5 m/s]). Indexed aortic valve calcium volume correlated with peak aortic jet velocity (ρ = 0.723; P < 0.001) and noncontrast CT calcium score (ρ = 0.896; P < 0.001). In the derivation cohort (n = 689), sex-specific thresholds for indexed calcium volume (men: 122 mm3/cm2; women: 61 mm3/cm2) provided excellent diagnostic discrimination for severe aortic stenosis (C-statistic: 0.900 for men; 0.926 for women). Similar diagnostic discrimination was observed in the validation cohort (n = 459; C-statistic: 0.933 for men; 0.944 for women). Clinical outcomes were available in 711 patients (25% with discordant echocardiography), with 249 reaching the primary endpoint after 26 months (Q1-Q3: 12-53 months). Indexed calcium volume thresholds were independently associated with aortic valve replacement or all-cause mortality in both the cohort as a whole (HR: 2.01 [95% CI: 1.30-3.10]; P < 0.01) and those with discordant echocardiography (HR: 1.58 [95% CI: 1.01-2.44]). ConclusionsIn patients with aortic stenosis, indexed aortic valve calcium volume from CTA provides accurate discrimination of disease severity and additive prognostic information. This technique can be easily applied to patients undergoing CTA for transcatheter aortic valve replacement or coronary artery evaluation without the need for a separate noncontrast CT scan.
Source: JACC. Cardiovascular imaging
Authors: Jolien Geers, Neil Craig, Kajetan Grodecki, Maria Lembo, Shruti S. Joshi, Trisha Singh, Rong Bing, Jacek Kwieciński, Lorenzo Carnevale, Dorien Kimenai, Soongu Kwak, Seung-Pyo Lee, Kush Patel, Thomas Treibel, Aroa Ruiz Muñoz, Jose F. Rodriguez Palomares, Jae-Kwan Song, Marie-Annick Clavel, Pamela Piña, Daniel Lorenzatti, Azeem Latib, Leandro Slipczuk, Ronak Rajani, Vitaliy Androshchuk, Julia Niemierko, Marek Grygier, Andrzej Walczak, Dariusz Jagielak, Marcin Protasiewicz, Wojciech Wojakowski, Janusz Kochman, Zenon Huczek, Nils Sofus Borg Mogensen, Jordi Sanchez Dahl, Vivek Patel, Tulika Garg, Hasan Jilaihawi, Raj Makkar, Steven Droogmans, Bernard Cosyns, Piotr Slomka, Michelle C. Williams, David E. Newby, Damini Dey, Marc R. Dweck
Institutions: Cedars-Sinai Medical Center, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, University of Edinburgh, Medical University of Warsaw, University of Naples Federico II, Institute of Cardiology, Istituto Neurologico Mediterraneo, Seoul National University, Seoul National University Hospital, Barts Health NHS Trust, University College London, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Instituto de Salud Carlos III, Asan Medical Center, University of Ulsan, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Albert Einstein College of Medicine, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, Gdańsk Medical University, Poznan University of Medical Sciences, Medical University of Lodz, Wroclaw Medical University, Medical University of Silesia, Odense University Hospital, Cedars-Sinai Smidt Heart Institute
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,000
Funders: Bristol-Myers Squibb, Pfizer, AstraZeneca, Suzuken Memorial Foundation, Japan Agency for Medical Research and Development, Cedars-Sinai Medical Center, Amarin Corporation, British Heart Foundation, University of Edinburgh, Ministry of Education, Culture, Sports, Science and Technology, Fundacja na rzecz Nauki Polskiej, Fonds Wetenschappelijk Onderzoek, Magyar Tudományos Akadémia, Nakatani Foundation for Advancement of Measuring Technologies in Biomedical Engineering, Vlaamse regering, European Association of Cardiovascular Imaging, Narodowa Agencja Wymiany Akademickiej, Silence Therapeutics, Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Medical Research Council, Japan Society for the Promotion of Science, Nemzeti Kutatási, Fejlesztési és Innovaciós Alap, National Heart, Lung, and Blood Institute
Awards: G1493233644, High-sensitivity cardiac troponin beyond the acute coronary syndrome, G178915608, G24867492, Mechanism of Molecular Levarage, G2992168593, G3420357660, G5379934826, G5460676972, Myocardial fibrosis activity in cardiovascular disease, G5845063458, G5923146098, The Right Timing to prevent Type 2 Diabetes: Restoring 24-hour substrate rhythmicity to improve glycemic control by timing of lifestyle factors, Integrated prediction of cardiovascular events by automated coronary plaque and pericoronary adipose tissue quantification from CT Angiography, G8157185085, Finding a cure for aortic stenosis, AI-enabled characterization of fibrocalcific aortic valve disease and inflammation from CT Angiography: Patient-specific outcome prediction
OpenAlex ID: W4415534340