Aortic valve calcium content does not predict aortic valve area.
OBJECTIVE
Aortic stenosis (AS) is a common clinical problem which frequently necessitates aortic valve replacement (AVR). The traditional view of progressive AS is a 1:1 inverse relationship between valve calcium content and aortic valve area (AVA). However, this assumption has been based on subjective estimates of calcification on chest X-radiographic images. The study aim was to evaluate the relationship between AVA as measured with echocardiography compared to calcium quantification using electron beam computed tomography (EBT).


METHODS
Sixty-one patients with an AVA between 0.7 and 2.0 cm2 underwent an EBT scan to evaluate the aortic valve calcium content.


RESULTS
The mean (+/- SD) aortic valve Agatston calcium score was 1,458.4 +/- 1,362.2, and for the aortic valve volume score was 1,178.8 +/- 1,066.0. The aortic valve Agatston score did not correlate strongly with AVA (r = -0.34, 95% CI -0.54, -0.09; p = 0.007). The data pattern appeared curvilinear, with the poorest correlation noted for those patients with moderate and severe aortic valve calcification.


CONCLUSIONS
The study findings support the hypothesis that the aortic valve orifice area decreases not only due to calcium accumulation but also to sclerotic processes.
Mohler
Emile R
ER
Department of Medicine, Cardiovascular Division, University of Pennsylvania School of Medicine, Philadelphia 19104, USA. mohlere@uphs.upenn.edu
Medenilla
Elizabeth
E
Wang
Hao
H
Scott
Craig
C
D000368:Aged; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D002114:Calcinosis; D002784:Cholesterol / Q000097:blood; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D002784:Cholesterol