scholarly journals QUANTIFYING AORTIC VALVE CALCIFICATION FROM A CONTRAST-ENHANCED CARDIAC COMPUTED-TOMOGRAPHY ANGIOGRAPHY STUDY

2015 ◽  
Vol 65 (10) ◽  
pp. A1170
Author(s):  
Abdulrahman Alqahtani ◽  
Kevin Boczar ◽  
Vinay Kansal ◽  
Girish Dwivedi ◽  
Kwan-Leung Chan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Computed Tomography Angiography ◽  
Cardiac Computed Tomography ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Cardiac Computed Tomography Angiography ◽  
Contrast Enhanced

Impact of pericoronary inflammation assessed by coronary computed tomography angiography on the progression of aortic valve calcification

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Misawa ◽  
T Sugiyama ◽  
Y Kanaji ◽  
M Hoshino ◽  
M Yamaguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Coronary Computed Tomography ◽  
The Mean ◽  
The Impact

Abstract Background Aortic valve calcification (AVC) has been known as an independent predictor for adverse cardiovascular events and all-cause mortality. Previous studies demonstrated that AVC was associated with aortic valve inflammation and atherosclerosis. However, the relationship between the progression of AVC and pericoronary inflammation remains undetermined. Purpose The purpose of this study was to evaluate the impact of the pericoronary inflammation on the progression of AVC. Methods A total of 107 patients with suspected or known chronic coronary syndromes who underwent clinically indicated serial 320-slice coronary computed tomography angiography (CTA) at Tsuchiura Kyodo General Hospital from January 2011 to June 2019 were retrospectively studied. Pericoronary inflammation was assessed by pericoronary adipose tissue attenuation (PCATA) defined as the mean CT attenuation value of PCATA (−190 to −30 Hounsfield units [HU]) on proximal 40 mm segments of coronary arteries. AVC was quantified by Agatston score on CTA. The mean aortic attenuation (HU Aorta) and the standard deviation (SD) in the region of interest at the level of the sinotubular junction was measured. AVC was defined as the threshold for calcium detection (mean HU Aorta + 2SD). AVC index was calculated as follows: (follow-up/baseline) AVC divided by follow-up period. AVC progression was defined as newly-developed AVC at follow-up or an increased AVC index during follow-up. All patients were divided into two groups according to the presence or absence of AVC progression, and clinical characteristics and CT findings were compared between these two groups. Results AVC progression was observed in 26 patients (24.3%) between 2 serial CT examinations (median, 34 months). There was no significant difference in age, gender and the prevalence of other cardiovascular risk factors between the 2 groups. Patients in AVC progression group were associated with higher prevalence of elevated PCATA-LAD, higher LV mass index at baseline and the initial AVC presence. Receiver-operating characteristic curve analysis revealed that the optimal cut off value of PCATA-LAD for predicting AVC progression was −68.26 HU (area under the curve 0.605; 95% confidence interval [CI], 0.465–0.745). Multivariable logistic regression analysis revealed that baseline PCATA-LAD ≥−68.26 HU (odds ratio [OR], 3.12; 95% CI, 1.04–9.35, p=0.042) and the presence of baseline positive AVC (OR, 6.84; 95% CI, 2.34–20.0, p=0.0004) were independent predictors of AVC progression. Conclusions The increased pericoronary inflammation and the presence of AVC may help identify patients with high risk for future AVC progression. Funding Acknowledgement Type of funding source: None

Abstract 20510: Aortic Valve Calcium Score for Paravalvular Aortic Insufficiency (AVCS II) Study in Transapical Aortic Valve Implantation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Martin Haensig ◽  
Lukas Lehmkuhl ◽  
Borek Foldyna ◽  
Axel Linke ◽  
Chirojit Mukherjee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Calcium Score ◽  
Aortic Valve Calcification ◽  
Valve Calcification ◽  
Contrast Enhanced ◽  
Aortic Valve Implantation ◽  
Enhanced Computed Tomography ◽  
Valve Implantation ◽  
Contrast Enhanced Computed Tomography

Introduction: Transapical-aortic valve implantation (TA-AVI) has evolved into a routine procedure in selected elderly high-risk patients. However, more-than-mild paravalvular leaks remain a significant drawback of current TAVI systems. The aim was to study the impact of native aortic valve calcification on paravalvular leaks in cardiac contrast-enhanced computed tomography (CT). Methods: The degree and distribution of native valve calcification were quantified using an Aortic Valve Calcium Score (AVCS) for each cusp separately (3mensio Valves™ workstation, version 7.0, 3mensio Medical Imaging B.V., Netherlands). To exclude an artificial increase of the AVCS due to the presence of contrast material, we used a threshold for density [mean aortic density + 2*D] and volume [0, 3, 5, 25 and 50 mm 3 ] of calcification. AVCS was compared to the rate of paravalvular leaks, assessed intraoperatively by echocardiography and root angiography. Results: Eighty-eight consecutive patients prior to TA-AVI with preoperative CT aged 80.0 ± 5.7 years, 51.1 % female were included. Three prosthesis sizes were used for annular diameters up to 23 mm (n = 29), 26 mm (n = 45) and 29 mm (n = 14). Mean log. EuroSCORE was 24.6 ± 15.4 % and mean STS-Score was 8.4 ± 8.3 %. The mean AVCS in patients without paravalvular leaks (n = 42) was 606.4 ± 374.3; with mild paravalvular leaks (n = 39) was 761.2 ± 530.4; and with moderate paravalvular leaks (n = 5) was 792.4 ± 515.3 with the highest calcification in the non-coronary cusp. There was no significant association between the total AVCS and paravalvular leaks (χ 2 -statistic = 2.9; P = 0.13, 551 hounsfield units). The additional use of the volume-based threshold did not lead to an increase of the association between the AVCS and paravalvular leakages. Paravalvular leaks were significantly associated with the degree (r Spearman = 0.34; χ 2 -statistic = 10.0; P = 0.02) and location of eccentric calcified plaques. Conclusions: Quantification of aortic valve calcification in contrast enhanced computed tomography shows only a weak correlation with paravalvular leakage and is therefore not reliable as a predictor, respectively. The degree of eccentric cusp calcification was significantly associated with the occurrence and location of paravalvular leaks.

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