What does this research mean for the field?

Planimetry using CTA (pAVACTA) indicates severe aortic valve stenosis at a cut-off ≤0.95cm², showing 87% sensitivity and 78.9% specificity compared to TTE. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to define the role of CTA-planimetry in assessing tricuspid aortic valve stenosis through cut-off determination.

February 8, 2026

Planimetry in aortic valve stenosis using computed tomography angiography - cut-off determination

Key Result

CTA-planimetry AVA ≤0.95cm² predicts severe aortic stenosis with 87% sensitivity and 78.9% specificity, aiding diagnosis when TTE is inconclusive.

Key Points

This research aims to define the role of CTA-planimetry in assessing tricuspid aortic valve stenosis through cut-off determination.
Retrospective study using 4059 pre-TAVI CTA scans from 2012 to 2023.
Selected 1161 conclusive cases based on TTE severity criteria.
Correlated CTA-planimetry (pAVACTA) values with echocardiography results to determine cut-off values.
pAVACTA exhibits strong positive correlation with echocardiography measured AV area (cAVATTE), Pearson correlation of 0.673, p<0.001.
Identified cut-offs indicate likely severe stenosis at pAVACTA ≤ 0.95 cm².
ROC analysis produced AUC of 0.888 for predicting severe stenosis with sensitivity of 87% and specificity of 78.9%.

Structured PICO

Does CTA-planimetry accurately predict severe tricuspid aortic valve stenosis compared to transthoracic echocardiography?

Population

1,161 patients with conclusive tricuspid aortic valve stenosis (derived from a retrospective screening of 4,059 pre-TAVI CTA scans)

Intervention

Aortic valve area measurement by CTA-planimetry (pAVACTA)

Comparator

Transthoracic echocardiography (TTE) calculated aortic valve area (cAVATTE) as the gold standard

Outcome

Correlation of pAVACTA to cAVATTE and diagnostic accuracy (cut-off values) for predicting severe stenosissurrogate

CTA-planimetry with a cut-off of ≤0.95cm² accurately identifies severe tricuspid aortic stenosis and can aid clinical decision-making when TTE results are inconclusive.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background Aortic valve (AV) stenosis is quantified by transthoracic echocardiography (TTE). However, stenosis severity can remain inconclusive when TTE severity parameters are incongruent. AV-area (AVA) by CTA-planimetry (pAVACTA) may aid in these cases. Objectives Defining the role of CTA-planimetry for tricuspid (TC) AV stenosis by cut-off determination. TTE of conclusive patients was used as Goldstandard. Methods Severity classification of AV stenosis was performed using TTE with classification into conclusive if all three of the following criteria were congruent: Vmax≥4m/s 1.0cm² (3+ "severe", 3- "non-severe"). Retrospective, single center screening of 4059 pre-TAVI-CTA-scans (2012-2023) yielded 1161 conclusive TC cases. Cut-off values for pAVACTA as a 4th severity criteria marker were determined by first correlating pAVACTA to cAVATTE directly and second by comparing different pAVACTA values for predicting "severe" stenosis via receiver operator curve (ROC). Results pAVACTA showed strong positive correlation with cAVATTE (Pearson-Correlation 0.673, p0.001) with Linear Regression yielding a correlating factor (contraction coefficient CC) of 0.91 (95% CI 0.895, 0.915, p0.001). ROC analysis (AUC 0.888, p0.001) yielded a cut-off range with severe stenosis "likely" at pAVACTA≤0.95cm² (Sens. 87%, Spec. 78.9% via Youden’s index) and "unlikely" at ≥1.1cm² (-LR 0.092 at 1.1cm²). Conclusion For a given pAVACTA the expected cAVATTE is smaller as the correlating factor (CC) is 1.0. Adding pAVACTA as a 4th AV-stenosis severity marker utilizing a newly defined cut-off range could aid decision making in patients with inconclusive TTE results. Further research is required to validate and narrow cut-off ranges and to test for clinical relevance.

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