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Aortic valve calcifications on chest films: how much calcium do I need?
MedLine Citation:
PMID:  21894808     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: Aortic valve calcifications (AVC) as seen on conventional chest films or on CT are associated with aortic valve stenosis (AVS). The absence of AVC on chest films does not exclude high grade AVS. The aim of this study was to analyse if there is a threshold for the detection of AVC from conventional chest films in patients suffering from high grade AVS.
METHODS AND RESULTS: The explanted aortic valves of 29 patients (16 male, mean age 72.3 +/- 11.5 years) with high grade AVS were examined by dual-source CT. AVC were quantified using the Agatston AVC score. In all patients conventional chest films obtained the day before surgery were evaluated for the presence of AVC. Results were analysed with students t-test, Spearman's rank correlation and ROC analysis. On conventional chest films AVC were visible in 18 patients. On CT all specimen presented with AVC with an Agatston AVC score ranging from 40.7 to 1870 (mean 991.3 +/- 463.1). In patients with AVC visible on chest films the AVC score was significantly higher (1264.0 +/- 318.2) when compared with patients without visible calcifications (544.9 +/- 274.4; P < 0.0001). There was a strong correlation between the AVC score and the visibility of AVC on chest films (r = 0.781). ROC analysis identified an ideal threshold of 718 for AVC score to separate conventional chest films with and without visible AVC.
CONCLUSION: Unlike in coronary calcifications, there is a threshold for identifying AVC from conventional chest films. This finding may be of diagnostic value, as conventional chest films may be used to semiquantitatively evaluate the extent of AVC.
Authors:
Andreas H Mahnken; Guido Dohmen; Ralf Koos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  66     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-09-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  505-8     Citation Subset:  IM    
Affiliation:
Department of Diagnostic and Interventional Radiology, University Hospital, RWTH Aachen University School of Medicine, Aachen, Germany. Mahnken@rad.rwth-aachen.de
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