Abstract 13370: Correlation between Topographic Distribution of Aortic Valve Calcium and Hemodynamic Repercussion in Aortic Stenosis
Purpose: There is evidence of association between aortic valve calcium score and severity of aortic stenosis (AS). However, there are no reports that correlate the topographic distribution of aortic valve calcium with possible hemodynamic impact in AS. The aim of this study is to verify the existence of this type of correlation.
Methods: Sixteen patients with degenerative AS, with mean peak transvalvular velocity of 3.65 ± 0.48 m/s, were prospectively submitted to a multidetector computed tomography for obtaining valve calcium score in Agatston units (AU). The peak transvalvular velocities were assessed by transthoracic echocardiography. The mean age was 68.7 ± 12.1 years. Patients with rheumatic or bicuspid etiology were excluded. The topographic distribuition of aortic valve calcium, assessed by computed tomography, determined two groups of patients: predominantly commissural (calcium located mainly in the region of aortic valve commissure) and predominantly non commissural (calcium located in the ring, leaflets and/or diffuse). Statistical comparisons were performed using Student’s t test or Fisher’s exact test, as appropriate.
Results: Patients with predominantly comissural aortic valve calcium (CC) had a calcium score significantly lower than those with predominantly non commissural calcium (CNC) (CC = 1242 ± 584.3 AU vs CNC = 2734 ± 1207.2 AU, p = 0.009) despite having similar peak transvalvular velocity (CC = 3.7 ± 0.42 m/s vs CNC = 3.5 ± 0.53 m/s, p = 0.21). There were no differences related to gender (p = 0.59) or age (CC = 66.5 ± 14.2 years vs. CNC = 70.4 ± 10.9 years, p = 0.54) between groups. There was no association between topographic distribution of aortic valve calcium and coronary artery calcium score.
Conclusion: In patients with AS, the location of valve calcium seems to be more important than the absolute tomographic calcium score. Even patients with low aortic valve calcium scores can have significant transvalvular velocities if the calcium is located predominantly in the commissural region.
- © 2013 by American Heart Association, Inc.