title: Geometrical characteristics of aortic root and left ventricular dysfunction in aortic stenosis: quantification of 256-slice coronary CT angiography.
abstract: The purpose of this study is to analyze the geometrical characteristics of aortic root and left ventricular (LV) function in aortic stenosis (AS) using 256-slice coronary-computed tomography angiography (CCTA). Retrospective ECG-gated 256-slice CCTA data from 32 patients with tricuspid AS scheduled for aortic valve replacement, and 11 controls were analyzed. Aortic root geometry was measured using multiplanar reconstruction CT images. CCTA data set was transformed into 100 phases/cycle using motion coherence image processing. Systolic shortening (SS, mm/ms) and diastolic relaxation (DR, mm/ms2) in the circumferential and longitudinal directions on time curves of myocardial length were calculated, and were used as estimates of geometric LV function. Comparison of parameters was analyzed by Mann-Whitney U test. Receiver-operating-characteristic (ROC) analysis was performed to determine the optimal cutoff of parameters for differentiating AS patients. Height of the right coronary cusp was significantly lower for AS patients than controls (11.4 ± 2.4 vs. 13.9 ± 2.0 mm/m2, p < 0.005). Vertical-longitudinal SS was significantly lower for AS patients than for controls (1.7 ± 0.8 vs. 2.7 ± 0.7 mm/ms/m2, p < 0.001). ROC analysis revealed optimal height of the right coronary cusp of 12.4 mm/m2and vertical-longitudinal SS of 2.4 mm/ms/m2for differentiating AS patients from controls, with C statistics of 0.82 and 0.85. In AS patients, ROC analysis revealed optimal vertical-longitudinal DR of 0.05 mm/ms2/m2for predicting patients with stroke volume index <35 ml with C statistics of 0.93. Quantification of CCTA demonstrates that AS is characterized by small coronary cusps as aortic root remodeling and vertical-longitudinal LV dysfunction related to restrictive physiology.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. nagao.michinobu@twmu.ac.jp.
authors.forename: Michinobu
authors.initials: M
authors.lastname: Nagao
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Yamasaki
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kamitani
authors.affiliation: Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawanami
authors.affiliation: Department of Medical Technology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kondo
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Sonoda
authors.affiliation: Philips Electronics Japan, Ltd., Tokyo, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Fujioka
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D000072226:Computed Tomography Angiography / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D061330:Multidetector Computed Tomography / Q000379:methods*; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D066253:Vascular Remodeling; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Aortic stenosis; Coronary-computed tomography angiography; Motion coherence analysis; Ventricular function