Prognostic value of multi-detector computed tomography in asymptomatic aortic valve stenosis

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• 作者：Linnea Hornbech Larsen^a ; ¹ ; ^{linnea@dadlnet.dk" class="auth_mail" title="E-mail the corresponding author} ; Klaus Fuglsang Kofoed^b ; ¹ ; Helle Gervig Carstensen^c ; ¹ ; Morten Dalsgaard^a ; ¹ ; Mads Kristian Ersb&oslash ; ll^a ; ¹ ; Lars K&oslash ; ber^a ; ¹ ; Christian Hassager^a ; ¹
• 关键词：AS ; aortic valve stenosis ; AU ; Agatston units ; AVA ; aortic valve area ; AVAi ; aortic valve area indexed by BSA ; AVC ; aortic valve calcification ; AV Vmax ; aortic valve peak velocity ; AVR ; aortic valve replacement ; BSA ; body surface area ; CACS ; coronary artery calcification score ; CAD ; coronary artery disease ; LV ; left ventricular ; LVEF ; left ventricular ejection fraction ; LVMi ; left ventricular mass indexed by BSA ; MDCT ; multi-detector computed tomography ; TAVI ; transcatheter aortic valve implanta
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 January 2016
• 年：2016
• 卷：203
• 期：Complete
• 页码：331-337
• 全文大小：789 K

文摘

Multi-Detector Computed Tomography (MDCT) is a high-resolution imaging technique with potential additive value in the evaluation of patients with aortic valve stenosis (AS). We aimed to assess the prognostic value of MDCT in asymptomatic patients with AS compared to conventional transthoracic echocardiography (TTE).

bsSec_2">Methods

116 patients with asymptomatic AS (Vmax > 2.5 m/s assessed by clinical screening TTE, LVEF > 50%) were examined with TTE (Vivid e9) and MDCT (Aquilion 320) on the same day. The treating physician was blinded for research protocol defined imaging results. Outcome was defined as indication for aortic valve replacement (AVR) determined by the treating physician or sudden cardiac death.

bsSec_3">Results

The mean age was 72 (8) years, 27% were women, mean AVA by TTE was 1.01 (0.30) cm². Median follow up time was 27 (IQR 19–44) months. Forty seven patients (41%) developed indication for AVR. No patients suffered a sudden cardiac death. AVA and aortic valve calcification were significant univariable predictors of AVR when measured by both TTE and MDCT, whereas left ventricular mass was only significant measured by MDCT. Significant coronary artery disease by MDCT tended to predict future indication for AVR, but this did not reach statistical significance (HR: 1.79 (95% CI 0.96–3.44), p = 0.08).

bsSec_4">Conclusion

MDCT derived AVA can be of use as an alternative to TTE derived AVA in patients with asymptomatic AS to predict future clinical indication for AVR.