Aortic valve calcium volume as measured by native versus contrast-enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in TAVR patients with low-gradient aortic stenosis
Abstract Background Most of TAVR centers evaluate the calcium score in contrast-enhanced (ce) CT. We compared in this study between different methodologies to measure calcium score. We studied also the difference between patients with low-gradient (LG) and high-gradient (HG) severe aortic stenosis (...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-09-01
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| Series: | The Egyptian Heart Journal |
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| Online Access: | https://doi.org/10.1186/s43044-022-00311-8 |
| _version_ | 1828108459685445632 |
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| author | Mohammad El Garhy Tamer Owais Philipp Lauten |
| author_facet | Mohammad El Garhy Tamer Owais Philipp Lauten |
| author_sort | Mohammad El Garhy |
| collection | DOAJ |
| description | Abstract Background Most of TAVR centers evaluate the calcium score in contrast-enhanced (ce) CT. We compared in this study between different methodologies to measure calcium score. We studied also the difference between patients with low-gradient (LG) and high-gradient (HG) severe aortic stenosis (AS) as regard the burden of aortic valve calcium (AVC). Results We measured the calcium volume and score using Agatston methodology in non-contrast (nc) CT and with modified and fixed 850 Hounsfield unit (HU) thresholds in ce CT. The calcium score and volume in ceCT using even with modified thresholds is significantly lower than the assessed score and volume in ncCT. The median (IQR) of calcium score in nc CT and in cc CT were 1288 AU (750–1815) versus 947 HU (384–2202). The median (IQR) of calcium volume in nc CT and in cc CT with modified thresholds were 701 mm3 (239–1632) versus 197 mm3 (139–532). Agatston score and calcium volume were lower in patients with LG AS than HG AS; 2069 AU (899–2477) versus 928AU (572–1284) and 1537 mm3 (644–1860) versus 286 mm3 (160–700), respectively. Only 20% of patients with LGAS had Agatston score higher than the previously supposed AVC score threshold for the diagnosis of severe AS (> 2000AU in men and > 1200 in women). Conclusions The diagnosis of severe LGAS should not depend on a single parameter as calcium score. In these patients, calcium score should be measured in nc CT and not in ce CT. |
| first_indexed | 2024-04-11T10:47:03Z |
| format | Article |
| id | doaj.art-c50b6c0f62a04ed790a565ab83e0b8db |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-04-11T10:47:03Z |
| publishDate | 2022-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-c50b6c0f62a04ed790a565ab83e0b8db2022-12-22T04:29:01ZengSpringerOpenThe Egyptian Heart Journal2090-911X2022-09-017411710.1186/s43044-022-00311-8Aortic valve calcium volume as measured by native versus contrast-enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in TAVR patients with low-gradient aortic stenosisMohammad El Garhy0Tamer Owais1Philipp Lauten2Department of Cardiology, Heart Centre, Zentralklinik Bad BerkaDepartment of Cardiac Surgery, University Hospital AugsburgDepartment of Cardiology, Heart Centre, Zentralklinik Bad BerkaAbstract Background Most of TAVR centers evaluate the calcium score in contrast-enhanced (ce) CT. We compared in this study between different methodologies to measure calcium score. We studied also the difference between patients with low-gradient (LG) and high-gradient (HG) severe aortic stenosis (AS) as regard the burden of aortic valve calcium (AVC). Results We measured the calcium volume and score using Agatston methodology in non-contrast (nc) CT and with modified and fixed 850 Hounsfield unit (HU) thresholds in ce CT. The calcium score and volume in ceCT using even with modified thresholds is significantly lower than the assessed score and volume in ncCT. The median (IQR) of calcium score in nc CT and in cc CT were 1288 AU (750–1815) versus 947 HU (384–2202). The median (IQR) of calcium volume in nc CT and in cc CT with modified thresholds were 701 mm3 (239–1632) versus 197 mm3 (139–532). Agatston score and calcium volume were lower in patients with LG AS than HG AS; 2069 AU (899–2477) versus 928AU (572–1284) and 1537 mm3 (644–1860) versus 286 mm3 (160–700), respectively. Only 20% of patients with LGAS had Agatston score higher than the previously supposed AVC score threshold for the diagnosis of severe AS (> 2000AU in men and > 1200 in women). Conclusions The diagnosis of severe LGAS should not depend on a single parameter as calcium score. In these patients, calcium score should be measured in nc CT and not in ce CT.https://doi.org/10.1186/s43044-022-00311-8TAVRComputed tomographyCalciumAortic valveLow-gradient aortic stenosis |
| spellingShingle | Mohammad El Garhy Tamer Owais Philipp Lauten Aortic valve calcium volume as measured by native versus contrast-enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in TAVR patients with low-gradient aortic stenosis The Egyptian Heart Journal TAVR Computed tomography Calcium Aortic valve Low-gradient aortic stenosis |
| title | Aortic valve calcium volume as measured by native versus contrast-enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in TAVR patients with low-gradient aortic stenosis |
| title_full | Aortic valve calcium volume as measured by native versus contrast-enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in TAVR patients with low-gradient aortic stenosis |
| title_fullStr | Aortic valve calcium volume as measured by native versus contrast-enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in TAVR patients with low-gradient aortic stenosis |
| title_full_unstemmed | Aortic valve calcium volume as measured by native versus contrast-enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in TAVR patients with low-gradient aortic stenosis |
| title_short | Aortic valve calcium volume as measured by native versus contrast-enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in TAVR patients with low-gradient aortic stenosis |
| title_sort | aortic valve calcium volume as measured by native versus contrast enhanced computer tomography and the implications for the diagnosis of severe aortic stenosis in tavr patients with low gradient aortic stenosis |
| topic | TAVR Computed tomography Calcium Aortic valve Low-gradient aortic stenosis |
| url | https://doi.org/10.1186/s43044-022-00311-8 |
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