Influence of aortic valve leaflet calcification on dynamic aortic valve motion assessed by cardiac computed tomography.
BACKGROUND
Computed tomography is the best noninvasive imaging modality for evaluating valve leaflet calcification.


OBJECTIVE
To evaluate the association of aortic valve leaflet calcification with instantaneous valve opening and closing using dynamic multidetector computed tomography (MDCT).


METHODS
We retrospectively evaluated 58 consecutive patients who underwent dynamic MDCT imaging. Aortic valve calcification (AVC) was quantified using the Agatston method. The aortic valve area (AVA) tracking curves were derived by planimetry during the cardiac cycle using all 20 phases (5% reconstruction). da/dt in cm2/s was calculated as the rate of change of AVA during opening (positive) or closing (negative). Patients were divided into 3 three groups according to Agatston score quartile: no AVC (Q2, Score 0, n = 18), mild AVC (Q3, Score 1-2254, n = 24), and severe AVC (Q4 Score >2254, n = 14).


RESULTS
In multivariable linear regression, compared to the non AVC group, the mild and severe AVC groups had lower maximum AVA (by -1.71 cm2and -2.25 cm2, respectively), lower peak positive da/dt (by -21.88 cm2/s and -26.65 cm2/s, respectively), and higher peak negative da/dt (by 13.78 cm2/s and 18.11 cm2/s, respectively) (p < 0.05 for all comparisons).


CONCLUSIONS
AVA and its opening and closing were influenced by leaflet calcification. The present study demonstrates the ability of dynamic MDCT imaging to assess quantitative aortic valve motion in a clinical setting.
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Keisuke
K
Minami
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Kihei
K
Yoneyama
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Masaki
M
Izumo
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Kengo
K
Suzuki
Radiological Technology, St. Marianna University School of Medicine, Kawasaki, Japan.
Yasuyoshi
Y
Ogawa
Radiological Technology, St. Marianna University School of Medicine, Kawasaki, Japan.
Kousuke
K
Chikaraishi
Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan.
Yukihisa
Y
Ogawa
Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan.
Yasuyuki
Y
Kobayashi
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Toshiyuki
T
Furukawa
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Yasuhiro
Y
Tanabe
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan. Electronic address: yoakashi-circ@umin.ac.jp.
Yoshihiro J
YJ
Akashi
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016014:Linear Models; D008297:Male; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
Aortic valve stenosis; Calcium score; Coronary angiography; Diagnosis; Echocardiography; Heart failure; Imaging