Abstract 2229: Usefulness of 64-Slice Multidetector-Row Computed Tomography in the Simultaneous Evaluation of Aortic Valve Area and Coronary Artery Stenosis in Patients with Aortic Valve Sclerosis
Multidetector-row computed tomography (MDCT) can provide an accurate imaging technique for quantification of aortic valve area (AVA) in patients with aortic valve stenosis. However, data in patients presenting aortic valve sclerosis without restrictive valve motion are scarce. The purpose of this study was to assess the ability of MDCT to evaluate AVA in comparison to the accepted diagnostic standard transthoracic echocardiography (TTE), and to identify coronary artery disease (CAD) in patients with aortic valve sclerosis. Forty consecutive patients (mean age of 72 years, range 57 to 87 years, 50% men) with aortic valve sclerosis were examined with TTE and 64-slice MDCT. The AVA with MDCT (AVACT) was estimated by quantitative planimetry after multi-planar reconstruction using the double-oblique method. AVACT was compared to the AVA with TEE by means of the planimetric method (AVA2D) and the continuity equation method (AVACE) using Pearson’s correlation analysis. Additionally, MDCT were evaluated for the presence or absence of coronary atherosclerotic plaque and the presence or absence of obstructive (50% lumen diameter reduction) CAD. The aortic valve could be visualized free of motion artifacts on all MDCT scans. The median AVACT, AVA2D, and AVACE were 2.65 ± 0.60 cm2, 2.55 ± 0.60 cm2, and 2.53 ± 0.57 cm2, respectively. Pearson’s correlation analysis revealed a strong correlation between AVACT and AVA2D (mean difference = 0.08 ± 0.09 cm2; r = 0.98; p < 0.001) and AVACT and AVACE (mean difference = 0.13 ± 0.21 cm2; r = 0.93; p < 0.001). Bland-Antman plot demonstrated a good intermodality agreement between MDCT and TTE with a slight overestimation of AVACT. CAD was observed in 36 patients, of whom 13 patients (33%) had non-obstructive and 23 patients (58%) had obstructive CAD, with the highly prevalence of multivessel disease (25%, n = 10). In only 4 patients (10%) of the study population, no coronary atherosclerotic plaques were detected. In patients with aortic valve sclerosis, 64-slice MDCT can provide an accurate imaging technique for quantification of AVA with the simultaneous evaluation of CAD. The prevalence of coronary atherosclerotic plaque and obstructive CAD is likely to be high in this setting.