Performance of Computed Tomographic Angiography-Based Aortic Valve Area for Assessment of Aortic Stenosis.

التفاصيل البيبلوغرافية
العنوان:	Performance of Computed Tomographic Angiography-Based Aortic Valve Area for Assessment of Aortic Stenosis.
المؤلفون:	Ash J; Cardiovascular Division, Department of Medicine University of Minnesota Medical School Minneapolis MN., Sandhu GS; Cardiovascular Division, Department of Medicine University of Minnesota Medical School Minneapolis MN.; Department of Medicine University of Minnesota Medical School Minneapolis MN., Arriola-Montenegro J; Department of Medicine University of Minnesota Medical School Minneapolis MN., Agakishiev D; Department of Medicine University of Minnesota Medical School Minneapolis MN., Clavel MA; Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec Heart and Lung Institute) Laval University Quebec City Canada., Pibarot P; Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec Heart and Lung Institute) Laval University Quebec City Canada., Duval S; Cardiovascular Division, Department of Medicine University of Minnesota Medical School Minneapolis MN., Nijjar PS; Cardiovascular Division, Department of Medicine University of Minnesota Medical School Minneapolis MN.
المصدر:	Journal of the American Heart Association [J Am Heart Assoc] 2023 Aug 15; Vol. 12 (16), pp. e029973. Date of Electronic Publication: 2023 Aug 10.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Oxford : Wiley-Blackwell
مواضيع طبية MeSH:	Aortic Valve/diagnostic imaging , Aortic Valve Stenosis/diagnostic imaging, Male ; Adult ; Humans ; Female ; Aged ; Aged, 80 and over ; Retrospective Studies ; Tomography, X-Ray Computed/methods ; Angiography ; Severity of Illness Index
مستخلص:	Background A total of 40% of patients with severe aortic stenosis (AS) have low-gradient AS, raising uncertainty about AS severity. Aortic valve calcification, measured by computed tomography (CT), is guideline-endorsed to aid in such cases. The performance of different CT-derived aortic valve areas (AVAs) is less well studied. Methods and Results Consecutive adult patients with presumed moderate and severe AS based on echocardiography (AVA measured by continuity equation on echocardiography <1.5 cm ² ) who underwent cardiac CT were identified retrospectively. AVAs, measured by direct planimetry on CT (AVA CT ) and by a hybrid approach (AVA measured in a hybrid manner with echocardiography and CT [AVA Hybrid ]), were measured. Sex-specific aortic valve calcification thresholds (≥1200 Agatston units in women and ≥2000 Agatston units in men) were applied to adjudicate severe or nonsevere AS. A total of 215 patients (38.0% women; mean±SD age, 78±8 years) were included: normal flow, 59.5%; and low flow, 40.5%. Among the different thresholds for AVA CT and AVA Hybrid , diagnostic performance was the best for AVA CT <1.2 cm ² (sensitivity, 85%; specificity, 26%; and accuracy, 72%), with no significant difference by flow status. The percentage of patients with correctly classified AS severity (correctly classified severe AS+correctly classified moderate AS) was as follows; AVA measured by continuity equation on echocardiography <1.0 cm ² , 77%; AVA CT <1.2 cm ² , 73%; AVA CT <1.0 cm ² , 58%; AVA Hybrid <1.2 cm ² , 59%; and AVA Hybrid <1.0 cm ² , 45%. AVA CT cut points of 1.52 cm ² for normal flow and 1.56 cm ² for low flow, provided 95% specificity for excluding severe AS. Conclusions CT-derived AVAs have poor discrimination for AS severity. Using an AVA CT <1.2-cm ² threshold to define severe AS can produce significant error. Larger AVA CT thresholds improve specificity.
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فهرسة مساهمة:	Keywords: aortic stenosis; computed tomography; echocardiography
SCR Disease Name:	Aortic Valve, Calcification of
تواريخ الأحداث:	Date Created: 20230815 Date Completed: 20230816 Latest Revision: 20230912
رمز التحديث:	20231215
مُعرف محوري في PubMed:	PMC10492957
DOI:	10.1161/JAHA.123.029973
PMID:	37581391
قاعدة البيانات:	MEDLINE

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تدمد:	2047-9980
DOI:	10.1161/JAHA.123.029973