Key result
Aortic valve calcium scoring accurately identified severe aortic stenosis in degenerative and bicuspid etiologies, but performed poorly in rheumatic cases.
Why the study?
Most studies of aortic valve calcium score in aortic stenosis focused on degenerative or bicuspid disease rather than rheumatic aortic stenosis.
Does aortic valve calcium scoring accurately identify severe aortic stenosis in patients with various etiologies?
Cross-Sectional (n=134)
No
Does aortic valve calcium scoring accurately identify severe aortic stenosis in patients with various etiologies?
Aortic valve calcium scoring accurately identifies severe aortic stenosis in degenerative and bicuspid etiologies but performs poorly in rheumatic aortic stenosis.
Answers are grounded in this paper and cite their sources.
May support AVC scoring for severe AS in degenerative/bicuspid valves; leaves open its utility in rheumatic cases.
Most of the studies about aortic valve calcium (AVC) score in aortic stenosis (AS) were based on degenerative or bicuspid AS but not rheumatic AS. We aimed to study the diagnostic accuracy of AVC score to determine severe AS in various etiologies. Adult patients diagnosed with mild to severe AS were enrolled. AVC score were identified from multi-detector computed tomography (MDCT) scan. The AVC score was highest in bicuspid AS (3211.9 (IQR (1100.0-4562.4) AU) compared to degenerative AS (1803.7 (IQR (1073.6-2550.6) AU)), and rheumatic AS (875.6 (IQR 453.3-1594.0) AU), p < 0.001. For the ROC curve to identify severe AS, the AVC score performed well in degenerative and bicuspid AS with the area under the ROC curve (AuROC) 0.834 (95% CI, 0.730, 0.938) in degenerative group; and 0.820 (95% CI, 0.687, 0.953) in bicuspid AS. Whereas AVC score had non-significant diagnostic accuracy with AuROC 0.667 (95% CI, 0.357, 0.976) for male and 0.60(95% CI, 0.243, 0.957) for female in rheumatic AS. The cut-off AVC score values to identify severe AS were AVCS > 2028.9AU (male) and > 1082.5AU (female) for degenerative AS, and > 2431.8AU (male) and > 1293.5AU (female) for bicuspid AS. In conclusions, AVC score is the accurate test for assessing severity in patients with degenerative and bicuspid AS but performs poorly in rheumatic AS group.
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Wanchaitanawong et al. (2023) conducted a cross-sectional in Aortic stenosis (degenerative, bicuspid, and rheumatic etiologies) (n=134). Aortic valve calcium (AVC) scoring vs. Echocardiography (reference standard) was evaluated on Diagnostic accuracy (Area under the ROC curve) to identify severe aortic stenosis (AuROC 0.834, 95% CI 0.730-0.938). Aortic valve calcium scoring accurately identified severe aortic stenosis in degenerative and bicuspid etiologies, but performed poorly in rheumatic cases.
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