Login
Search
Search
0 Dates
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Total fibrocalcific burden of the aortic valve in patients with aortic stenosis – assessment by a new CT method and comparative performance with calcium scoring
Session:
SESSÃO DE POSTERS 39 - IMAGEM CARDÍACA NA ESTENOSE AÓRTICA
Speaker:
Ana Rita Bello
Congress:
CPC 2025
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.2 Computed Tomography
Session Type:
Cartazes
FP Number:
---
Authors:
Ana Rita Bello; Kamil Stankowski; Débora Silva Correia; Pedro Lopes; Francisco Gama; Cláudia Silva; Pedro Freitas; Sara Guerreiro; João Abecasis; António Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Introduction:</strong> </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Calcium scoring of the aortic valve (VCaS) is a useful tool for assessing severity of aortic stenosis (AS), but focuses solely on the calcific component, overlooking the contribution of fibrosis. Recently, a novel method for quantifying both fibrosis and calcification of the aortic valve in contrast-enhanced CT has been developed and validated histologically. This study aimed to characterize the fibrocalcific burden of the aortic valves of patients with AS undergoing cardiac CT, and compare its discriminative value with VCaS. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Methods: </strong>This single center retrospective<strong> </strong>study included patients with isolated degenerative AS with normal flow conditions on transthoracic echocardiogram (performed within 6 months) who underwent cardiac CT for the workup of known or suspected severe AS. Fibrotic volume, calcific volume and fibrocalcific volume (FCV) were calculated on CT images according to the new methodology, using Gaussian-mixture-modeling to derive scan-specific thresholds for calcific and fibrotic tissue. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Results: </strong></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">A total of 246 patients were included (mean age 81 ± 7 years; 64% female). Overall, 198 patients had severe aortic AS and 48 had moderate AS. Population characteristics are described in Table 1.FCV and fibrotic volume showed poor correlation with mean gradient (rho = 0.280, p <0.001; rho=0.125, p=0.051, respectively). Median FCV was higher in patients with severe AS than in those with moderate AS (2616 vs. 2037 mm3; p=0.025). This difference was mainly due to increased calcium content (714 vs 420 mm3; p=0.021), as there were no differences in fibrotic content between groups (1830 vs 1310; p=0.126). </span></span></p> <p><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">Total fibrotic volume was not different between genders, but the fibrocalcific ratio (fibrous / calcific volume) was higher in females with severe AS (p<0.001).<br /> FCV showed a C-statistic of 0.65 (95%CI 0.56– 0.75; p=0.001) for prediction of severe AS. However, VCaS remained superior to FCV in predicting severe AS (C-statistic 0.79 (95%CI 0.71-0.86, p<0.001), p<0.001 for comparison between the two. The discriminative power of VCaS remained superior to FCV in both men and women. Results remained similar when FCV or its individual components were indexed to the patient’s aortic annulus dimensions.<br /> A small group of patients (n=17) underwent a second CT during follow-up (median interscan time 917 days, IQR 475-1595). An increase in both fibrosis and calcium was noted, with a significant rise in total fibrocalcific content over time (p=0.045).</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion: </strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Aptos,sans-serif">The fibrous and calcific components of the aortic valve differ significantly between patients, vary by sex, and evolve over time. However, the quantification of total fibrocalcific volume did not outperform calcium score in identifying severe AS. Further studies in larger cohorts are warranted to explore the clinical relevance of fibrosis quantification, particularly in female patients.</span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site