Aortic Valve Calcium Score Quantification by Contrast Cardiac CT: Correlations With Echocardiography and Optimal...

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Aortic valve calcium score (AVCa) on noncontrast CT is standard for grading aortic stenosis (AS) severity.
• Thresholds for AVCa on contrast CT are not well-established.
• This study evaluates AVCa on contrast CT against transthoracic echocardiography (TTE) for AS severity.

Purpose of the Study:

• To determine correlations and associated factors of AVCa measured on contrast CT.
• To establish severity thresholds of AVCa on contrast CT for identifying severe AS.
• To compare AVCa on contrast CT with TTE measures of AS.

Main Methods:

• Retrospective study of 1035 patients undergoing TTE and contrast-enhanced CT for AS evaluation.
• AVCa measured using modified Agatston method.
• Receiver-operating characteristics analysis and Youden index used to define sex-specific optimal AVCa thresholds for severe AS.

Main Results:

• Multivariable analysis showed women had lower AVCa, while chronic kidney disease was associated with higher AVCa.
• Optimal severe AS thresholds: ≥1840 modified AU for men and ≥1430 modified AU for women.
• High sensitivity and specificity for identified thresholds in both derivation and validation cohorts.

Conclusions:

• AVCa measured on contrast CT is a valuable tool for identifying severe AS.
• Sex-specific thresholds for severe AS using contrast CT AVCa were identified.
• Further external validation and prognostic studies are warranted.