Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;33(3):1963-1972.
doi: 10.1007/s00330-022-09133-3. Epub 2022 Sep 16.

Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT

Soojung Park  1 , Yongwon Cho  1 , Yu-Whan Oh  1 , Minseok Ko  2 , Do-Sun Lim  3 , Cheol Woong Yu  3 , Seong-Mi Park  3 , Mi-Na Kim  3 , Sung Ho Hwang  4
Affiliations

Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT

Soojung Park et al. Eur Radiol. 2023 Mar.

Abstract

Objective: To demonstrate the relationship between spectral computed tomography (CT) measured iodine concentration and strength of aortic valvular calcification (AVC) in patients with aortic valve stenosis (AVS).

Methods: A retrospective study was performed on patients who underwent transcatheter aortic valve replacement (TAVR) for symptomatic AVS and underwent both pre and postprocedural electrocardiogram gated CT scans using a spectral CT system. Preprocedural CT was used to evaluate the volume and iodine concentration (IC) in the AVC. Postprocedural CT data were used to calculate the volume reduction percentage (VRP) of AVC. Multiple linear regression analysis was used to identify the independent variables related to the VRP in AVCs.

Results: A total of 94 AVCs were selected from 22 patients. The mean volume and IC of the AVCs before TAVR were 0.37 mL ± 0.15 mL and 7 mg/mL ± 10.5 mg/mL, respectively. After TAVR, a median VRP of all 94 AVCs was 18.5%. Multiple linear regression analysis showed that the IC was independently associated with the VRP (coefficient = 1.64, p < 0.001). When an optimal IC cutoff point was set at 4 mg/mL in the assessment of a fragile AVC which showed the VRP was > 18.5%, the sensitivity was 63%; specificity, 91%; positive predictive value, 88%; and negative predictive value, 71%.

Conclusions: When using spectral CT to prepare the TAVR, measuring the IC of the AVC may be useful to assess the probability of AVC deformity after TAVR.

Key points: • A dual-layer detector-based spectral CT enables quantifying iodine of contrast media in the aortic valve calcification (AVC) on contrast-enhanced CT images. • The AVC including iodine of contrast media on contrast-enhanced CT image may have loose compositions, associated with the deformity of AVC after TAVR. • Measuring the iodine concentration in AVC may have the potential to assess the probability of AVC deformity, which may be associated with the outcome and complications after TAVR.2.

Keywords: Aortic valve; Aortic valve stenosis; Calcification; Computed tomography; Transcatheter aortic valve replacement.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Stritzke J, Linsel-Nitschke P, Markus MR et al (2009) Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey. Eur Heart J 30:2044–2053 - DOI - PubMed
    1. Pawade TA, Newby DE, Dweck MR (2015) Calcification in aortic stenosis: the skeleton key. J Am Coll Cardiol 66:561–577 - DOI - PubMed
    1. Prendergast B, Vahanian A (2022) The 2021 ESC/EACTS guidelines for the management of valvular heart disease: a new template for Heart Teams and their patients. Cardiovasc Res 118:e11–e13 - DOI - PubMed
    1. Kapadia SR, Leon MB, Makkar RR et al (2015) 5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet 385:2485–2491 - DOI - PubMed
    1. Leon MB, Smith CR, Mack M et al (2010) Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 363:1597–1607 - DOI - PubMed

MeSH terms

Supplementary concepts

LinkOut - more resources