Correlation of Computed Tomography-derived Aortic Valve Calcium Score with Severity of Aortic Stenosis on Echocardiography: A Single-Center Experience

Congress:

ECR 2020

Poster Number:

C-12320

Type:

Scientific Exhibit

Keywords:

Cardiac, Arteries / Aorta, Vascular, CT, MR-Angiography, Diagnostic procedure, Arteriosclerosis, Calcifications / Calculi, Retrospective, Observational, Performed at one institution

Authors:

L. T. Tan¹, T. L. J. Razon², L. Cuenza³; ¹Bonifacio Global City/PH, ²Quezon City/PH, ³Manila/PH

DOI:

10.26044/ecr2020/C-12320

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-12320

Fig. 1: Double-oblique multiplanar reconstruction CT image at the level of the aortic...

Fig. 2: Coronal reconstructed CT image of the aortic root showing severe asymmetric...

Fig. 3: Double-oblique multiplanar reconstruction CT image at the level of the aortic...

Fig. 4: Aortic Valve Calcium Score. Calcium scoring of the aortic valve using...

Purpose

Among Filipino patients diagnosed with aortic stenosis at our institution, the authors sought to 1.) Investigate the correlation of CT-derived aortic valve calcium score (AVCS) measured in Agatston Units (AU) with the echocardiographic severity of aortic stenosis and 2.) Determine an optimal AVCS cut-off value in predicting severe aortic stenosis.

Methods and materials

Patient population: This single-center retrospective study included 28 consecutive Filipino patients who underwent both transthoracic echocardiogram and CT scan with transcatheter aortic valve implantation (TAVI) protocol from October 2017 to November 2018. Inclusion Criteria: Adult Filipino patients >50 years old and with morphologically tricuspid aortic valves. The interval between echocardiographic and CT studies was at least < 6 months apart. Exclusion Criteria: Patients with chest implants causing beam hardening artifacts. Variant valvular anatomy (e.g. Quadri- and bi-cuspid aortic valves) which are prone to premature degenerative...

Results

The 28 Filipino patients included in the study were mostly males (64.3%), ages ranging from 53 to 94 years old, and mean age of 78 years old. Twenty-six patients (93%)had hypertension, while half of them had diabetes mellitus and only 1 patient was a smoker (with 20-pack year history). The baseline clinical and imaging data are listed in Table 1. Echocardiographic data: Eighty-six percent (86%) of the patients had severe aortic stenosis. The meanAVA was 0.78 cm2, the mean ejection fraction was 58%, the meanMPG...

Conclusion

In this study, statistical analyses showed that an increasing CT-derived AVCS is significantly correlated to the worsening of ejection fraction but is not significantly correlated to the otherecho-derived and CT-derived parameters of aortic stenosis severity. However, the discriminative power of AVCS is less than adequate. An AVCS of >2155 AU has fair sensitivity but poor specificity in predicting the severity of echocardiographic indices of aortic stenosis.

Personal information and conflict of interest

L. T. Tan; Bonifacio Global City/PH - nothing to disclose T. L. J. Razon; Quezon City/PH - nothing to disclose L. Cuenza; Manila/PH - nothing to disclose

References

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