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Aortic valve calcification volume and prognosis in patients undergoing transcatheter aortic valve implantation

Héctor A Álvarez-Covarrubias1, Niklas Altaner2, Rafael Adolf3

  • 1Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; Departamento de Cardiología, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro (IMSS), México City, Mexico.

Revista Espanola De Cardiologia (English Ed.)
|October 26, 2024
PubMed

Insights

Aortic valve calcium volume measured by contrast-enhanced computed tomography angiography (angio-CT) correlates with non-contrast imaging and predicts mortality. Higher calcium volumes in patients undergoing transcatheter aortic valve implantation (TAVI) are associated with lower one-year mortality.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Assessing aortic valve calcium is crucial for patients undergoing transcatheter aortic valve implantation (TAVI).
  • The prognostic value of aortic valve calcium volume measured by contrast-enhanced computed tomography angiography (angio-CT) in TAVI patients remains unclear.

Purpose of the Study:

  • To determine if contrast-enhanced angio-CT aortic valve calcium volume correlates with noncontrast-enhanced calcium scores.
  • To investigate the association between contrast-enhanced angio-CT aortic valve calcium volume and mortality in TAVI patients.

Main Methods:

  • Retrospective observational study at two German TAVI centers.
  • Calcium volume quantified using 3Mensio software on contrast-enhanced angio-CT, validated against noncontrast-enhanced angio-CT calcium scores.
  • Cox proportional hazard regression analysis used to assess mortality risk based on dichotomized, sex-specific calcium volume.

Main Results:

  • 3318 TAVI patients included; strong correlation between noncontrast-enhanced and contrast-enhanced angio-CT calcium (r²=0.680, P<.001).
  • Sex-specific median calcium volumes: 514 mm³ for women, 1025 mm³ for men.
  • Higher calcium volumes were associated with significantly lower one-year mortality (8.8% vs 12.1%; adjusted HR 0.86, P=.02).

Conclusions:

  • Contrast-enhanced angio-CT aortic valve calcium volume is a reliable measure, correlating well with noncontrast-enhanced scores.
  • Increased aortic valve calcium volume in TAVI patients is linked to reduced one-year mortality, suggesting prognostic utility.
Abstract

Keywords:
Aortic valve calcificationAortic valve stenosisCalcificación valvular aórticaCalcium volumeEstenosis valvular aórticaImplante percutáneo de válvula aórticaTranscatheter aortic valve implantationVolumen de calcio

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