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Computed Tomography Aortic Valve Calcium Scoring in Patients With Aortic Stenosis
- Source :
- Circulation: Cardiovascular Imaging. 11
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Background— Computed tomography aortic valve calcium scoring (CT-AVC) holds promise for the assessment of patients with aortic stenosis (AS). We sought to establish the clinical utility of CT-AVC in an international multicenter cohort of patients. Methods and Results— Patients with AS who underwent ECG-gated CT-AVC within 3 months of echocardiography were entered into an international, multicenter, observational registry. Optimal CT-AVC thresholds for diagnosing severe AS were determined in patients with concordant echocardiographic assessments, before being used to arbitrate disease severity in those with discordant measurements. In patients with long-term follow-up, we assessed whether CT-AVC thresholds predicted aortic valve replacement and death. In 918 patients from 8 centers (age, 77±10 years; 60% men; peak velocity, 3.88±0.90 m/s), 708 (77%) patients had concordant echocardiographic assessments, in whom CT-AVC provided excellent discrimination for severe AS (C statistic: women 0.92, men 0.89). Our optimal sex-specific CT-AVC thresholds (women 1377 Agatston unit and men 2062 Agatston unit) were nearly identical to those previously reported (women 1274 Agatston unit and men 2065 Agatston unit). Clinical outcomes were available in 215 patients (follow-up 1029 [126–2251] days). Sex-specific CT-AVC thresholds independently predicted aortic valve replacement and death (hazard ratio, 3.90 [95% confidence interval, 2.19–6.78]; P P =0.010). Conclusions— Sex-specific CT-AVC thresholds accurately identify severe AS and provide powerful prognostic information. These findings support their integration into routine clinical practice. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifiers: NCT01358513, NCT02132026, NCT00338676, NCT00647088, NCT01679431.
- Subjects :
- Male
Aortic valve
medicine.medical_specialty
030204 cardiovascular system & hematology
Severity of Illness Index
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Aortic valve replacement
Internal medicine
Multidetector Computed Tomography
Severity of illness
medicine
Humans
Radiology, Nuclear Medicine and imaging
Prospective Studies
Registries
Prospective cohort study
Aged
Aged, 80 and over
business.industry
Hazard ratio
Calcinosis
Aortic Valve Stenosis
Prognosis
medicine.disease
Echocardiography, Doppler
Confidence interval
Stenosis
medicine.anatomical_structure
Aortic Valve
Heart Valve Prosthesis
Aortic valve stenosis
Cardiology
Calcium
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 19420080 and 19419651
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Circulation: Cardiovascular Imaging
- Accession number :
- edsair.doi.dedup.....5b4af74e964c872ff9799d1ff5f012f2