Aortic valve calcification as a marker for aortic stenosis severity:: Assessment on 16-MDCT
Aortic valve calcification as a marker for aortic stenosis severity:: Assessment on 16-MDCT
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DOI：
10.2214/ajr.183.6.01831813
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发表时间：
2004-12-01
影响因子：
5
通讯作者：
Kühl, HP
中科院分区：
文献类型：
--
作者：
Koos, R;Mahnken, AH;Kühl, HP
OBJECTIVE.主动脉瓣狭窄患者的瓣膜钙化程度通过回顾性ECG门控16-MDCT确定，并与心导管检查评估的狭窄严重程度相关。我们对72例接受16-MDCT和心导管检查的主动脉瓣狭窄患者（38例男性和34例女性;平均年龄+/- SD，69.5 +/- 8.8岁）进行了前瞻性研究。使用主动脉Agatston评分、主动脉质量评分和主动脉体积评分评估主动脉瓣钙化。在心导管检查时对主动脉瓣狭窄的严重程度进行分类。主动脉瓣面积、峰-峰和平均跨瓣压差与MDCT上确定的钙化程度相关。重度主动脉瓣狭窄患者（n = 46）所有测量的主动脉瓣钙化评分均显著高于中度（n = 15）或轻度（n = 11，p < 0.001）主动脉瓣狭窄患者。主动脉瓣钙化评分与主动脉瓣面积呈负相关（主动脉瓣质量评分r =-0.67，p < 0.001），与峰间压差（r = 0.70，p < 0.001）和平均跨瓣压差（r = 0.72，p < 0.001）显著相关。主动脉瓣钙化与冠状动脉钙化积分无相关性。16-MDCT评估的主动脉瓣钙化与主动脉瓣狭窄的严重程度相关。因此，应在所有接受MDCT的患者中常规计算主动脉瓣钙化评分，以评估冠状动脉钙化。高主动脉瓣钙化评分提示可能存在重度主动脉瓣狭窄，应提示进一步的功能评价。
OBJECTIVE. The degree of valvular calcification in patients with aortic stenosis was determined with retrospectively ECG-gated 16-MDCT and correlated with the severity of stenosis assessed at cardiac catheterization.SUBJECTS AND METHODS. We conducted a prospective study of 72 patients (38 men and 34 women; mean age +/- SD, 69.5 +/- 8.8 years) with aortic stenosis who underwent 16-MDCT and cardiac catheterization. Aortic valve calcification was assessed using the aortic Agatston score, aortic mass score, and aortic volume score. Severity of aortic stenosis was classified at cardiac catheterization. Aortic valve area and peak-to-peak and mean transvalvular gradients were correlated with the degree of calcification determined on MDCT.RESULTS. All measured aortic valve calcification scores were significantly higher in patients with severe aortic stenosis (n = 46) than in patients with moderate (n = 15) or mild (n = 11, p < 0.001) aortic stenosis. Aortic valve calcification scores were inversely related to aortic valve area (r = -0.67, p < 0.001 for aortic mass score) and correlated significantly with peak-to-peak (r = 0.70, p < 0.001) and mean transvalvular (r = 0.72, p < 0.001) gradients. No correlation between the aortic valve calcification and the total coronary calcium scores was observed.CONCLUSION. Aortic valve calcification assessed on 16-MDCT is associated with severity of aortic stenosis. Thus, aortic valve calcification scores should be calculated routinely in all patients undergoing MDCT for assessment of coronary calcification. High aortic valve calcification scores indicate possibly severe aortic stenosis and should prompt a further functional evaluation.