Prognostic value of multi-detector computed tomography in asymptomatic aortic valve stenosis. (15th January 2016)

• Record Type: Journal Article
• Authors: Larsen, Linnea Hornbech; Kofoed, Klaus Fuglsang; Carstensen, Helle Gervig; Dalsgaard, Morten; Ersbøll, Mads Kristian; Køber, Lars; Hassager, Christian
• Is Part Of: International journal of cardiology. Volume 203(2016)
• Page Start: 331
• Page End: 337
• Publication Date: 2016-01-15
• Subjects: 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 implantation -- TTE transthoracic echocardiographic -- VTI volume time integral; Aortic valve stenosis -- Multi-detector computed tomography -- Aortic valve area -- Left ventricular mass -- Coronary artery disease -- Aortic valve calcification; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2015.10.088
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: 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). 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. Results: The mean age was 72 (8) years, 27% were women, mean AVA by TTE was 1.01 (0.30) cm 2 . 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). 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.