title: Aortic valve calcium content does not predict aortic valve area.
abstract: 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.
authors.affiliation: Department of Medicine, Cardiovascular Division, University of Pennsylvania School of Medicine, Philadelphia 19104, USA. mohlere@uphs.upenn.edu
authors.forename: Emile R
authors.initials: ER
authors.lastname: Mohler
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Medenilla
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.forename: Craig
authors.initials: C
authors.lastname: Scott
mesh_terms: 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
chemical_list: D014280:Triglycerides; D002784:Cholesterol