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Diagnostic and Prognostic Performance of Aortic Valve Calcium Score with Cardiac CT for Aortic Stenosis: A

Tom Kai Ming Wang1, Scott D Flamm1, Paul Schoenhagen1

  • 1Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195 (T.K.M.W., B.P.G., L.L.R., R.A.G., B.X.); and Cardiovascular Imaging Laboratory, Imaging Institute, Cleveland Clinic, Cleveland, Ohio (T.K.M.W., S.D.G., P.S., L.L.R., R.A.G., B.X.).

Radiology. Cardiothoracic Imaging
|September 9, 2021
PubMed

Insights

The aortic valve calcium score (AVCS) using CT effectively identifies severe aortic stenosis (AS) and predicts mortality. Mean AVCS values, categorized by AS severity, can aid clinical decisions.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Medical Diagnostics

Background:

  • Aortic stenosis (AS) is a significant cardiovascular condition.
  • Accurate diagnosis and risk stratification are crucial for managing AS.
  • The aortic valve calcium score (AVCS) using computed tomography (CT) is a potential tool for AS assessment.

Purpose of the Study:

  • To evaluate the diagnostic performance of AVCS using CT for identifying severe AS.
  • To assess the prognostic value of AVCS in patients with AS.
  • To determine mean AVCS values across different AS severity grades.

Main Methods:

  • A meta-analysis of studies published from 1980 to 2020 was conducted.
  • Searched databases included PubMed, Embase, and Cochrane.
  • Data on sensitivity, specificity, mean AVCS, and hazard ratios were pooled using random effect models.

Main Results:

  • Twelve studies involving 4101 patients were analyzed.
  • Pooled sensitivity and specificity for severe AS were 82% and 78%, respectively.
  • Mean AVCS differed significantly across AS severity: severe (3219), moderate (1808), mild (584).
  • AVCS predicted all-cause mortality with a hazard ratio of 2.11.

Conclusions:

  • AVCS demonstrates moderate to high accuracy in diagnosing severe AS.
  • AVCS serves as a valuable prognostic marker for mortality in AS.
  • Mean AVCS, stratified by AS severity, can inform clinical management strategies.
Abstract

Keywords:
Aortic ValveCTMeta-AnalysisValves

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