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
Review
. 2024 Jul 11;13(14):4064.
doi: 10.3390/jcm13144064.

Aortic Valve Calcium Score: Applications in Clinical Practice and Scientific Research-A Narrative Review

Paweł Gać  1   2 , Arkadiusz Jaworski  3 , Filip Grajnert  4 , Katarzyna Kicman  3 , Agnieszka Trejtowicz-Sutor  1 , Konrad Witkowski  1 , Małgorzata Poręba  5 , Rafał Poręba  6
Affiliations
Review

Aortic Valve Calcium Score: Applications in Clinical Practice and Scientific Research-A Narrative Review

Paweł Gać et al. J Clin Med. .

Abstract

In this narrative review, we investigate the essential role played by the computed tomography Aortic Valve Calcium Score (AVCS) in the cardiovascular diagnostic landscape, with a special focus on its implications for clinical practice and scientific research. Calcific aortic valve stenosis is the most prevalent type of aortic stenosis (AS) in industrialized countries, and due to the aging population, its prevalence is increasing. While transthoracic echocardiography (TTE) remains the gold standard, AVCS stands out as an essential complementary tool in evaluating patients with AS. The advantage of AVCS is its independence from flow; this allows for a more precise evaluation of patients with discordant findings in TTE. Further clinical applications of AVCS include in the assessment of patients before transcatheter aortic valve replacement (TAVR), as it helps in predicting outcomes and provides prognostic information post-TAVR. Additionally, we describe different AVCS thresholds regarding gender and the anatomical variations of the aortic valve. Finally, we discuss various scientific studies where AVCS was applied. As AVCS has some limitations, due to the pathophysiologies of AS extending beyond calcification and gender differences, scientists strive to validate contrast-enhanced AVCS. Furthermore, research on developing radiation-free methods of measuring calcium content is ongoing.

Keywords: AVC; CT-AVC; aortic valve calcification score; aortic valve stenosis; artificial intelligence; bicuspid; calcium scoring; echocardiography; multidetector computed tomography.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Examples of cardiac computed tomography images in the AVCS assessment protocol: (A) 67-year-old woman with AVCS 1578; (B) 74-year-old man with AVCS 5323 (images from P.G.’s clinical practice). Purple—calcifications in the aortic valve, yellow—calcifications in the LAD branch, blue—calcifications in the LCx branch, pink—calcifications in other anatomical structures, red—calcifications in the RCA.
Figure 2
Figure 2
Sample images of the aortic valve in cardiac computed tomography: (A) bicuspid aortic valve; (B) tricuspid aortic valve (images from P.G.’s clinical practice).
Figure 3
Figure 3
AVA measurement in an example computed tomography cardiac image (from P.G.’s clinical practice). In the application from which the image originates, [1] signifies a measurement made, which is described in the following text.
Figure 4
Figure 4
Elementary measurements in cardiac computed tomography before TAVR: (A) Dimensions, circumference, and surface area of the aortic annulus. (B) Dimensions, circumference, and surface area of the aortic bulb. (C) Distance of the RCA origin from the aortic annulus. (D) Distance of the LM origin from the aortic annulus. (E) Aortic bulb height (images from P.G.’s clinical practice).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Rozeik M., Wheatley D., Gourlay T. The aortic valve: Structure, complications and implications for transcatheter aortic valve replacement. Perfusion. 2014;29:285–300. doi: 10.1177/0267659114521650. - DOI - PubMed
    1. Kawahara Y., Suzuki K., Takahara S., Fukasawa M. Congenital unicuspid aortic valve stenosis in siblings. Gen. Thorac. Cardiovasc. Surg. 2014;62:567–569. doi: 10.1007/s11748-013-0270-0. - DOI - PubMed
    1. Al Ansari A.E., Abdulrahman A., Shaikho N.M.G., Saif S.A. A very rare cause of aortic regurgitation: Pentacuspid aortic valve. Eur. Heart J. Case Rep. 2021;5:ytab038. doi: 10.1093/ehjcr/ytab038. - DOI - PMC - PubMed
    1. Amoakwa K., Fashanu O.E., Tibuakuu M., Zhao D., Guallar E., Whelton S.P., O’Neal W.T., Post W.S., Budoff M.J., Michos E.D. Resting heart rate and the incidence and progression of valvular calcium: The Multi-Ethnic Study of Atherosclerosis (MESA) Atherosclerosis. 2018;273:45–52. doi: 10.1016/j.atherosclerosis.2018.04.004. - DOI - PMC - PubMed
    1. Messika-Zeitoun D., Bielak L.F., Peyser P.A., Sheedy P.F., Turner S.T., Nkomo V.T., Breen J.F., Maalouf J., Scott C., Tajik A.J., et al. Aortic valve calcification: Determinants and progression in the population. Arterioscler. Thromb. Vasc. Biol. 2007;27:642–648. doi: 10.1161/01.ATV.0000255952.47980.c2. - DOI - PubMed

LinkOut - more resources