Preliminary experience in the use of ultrafast computed tomography to diagnose aortic valve stenosis

MacMillan, Robert M.; Rees, Michael R.; Lumia, Frank J.; Maranhão, Vladir

doi:10.1016/0002-8703(88)90818-6

Cited by 17 publications

(7 citation statements)

References 21 publications

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“…18 -22 Some studies suggested the use of EBT or computed tomography to detect and quantify aortic valve calcification. [23][24][25] A weak correlation between the extent of calcification and the severity of aortic valve stenosis has been described. 25 We therefore used EBT in a group of 104 patients to quantify the extent of aortic valve calcification, to determine the rate of progression, and to analyze the influence of cardiovascular risk factors on the course of aortic valve calcification.…”

Section: See P 1881mentioning

confidence: 99%

Progression of Aortic Valve Calcification

et al. 2001

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Background-Recent studies demonstrated an influence of atherosclerotic risk factors on the progression of aortic valve stenosis. The extent of aortic valve calcification (AVC) was also found to be a strong predictor of stenosis progression. We investigated the influence of the LDL cholesterol level (LDL), other standard cardiovascular risk factors, and the extent of coronary calcification (CC) on the progression of AVC quantified by electron beam tomography (EBT). Methods and Results-In 104 patients (64.7Ϯ8 years, 89 male) with an EBT scan positive for AVC, CC and AVC were quantified using a volumetric score. EBT was repeated at a mean interval of 15 months (10 to 36 months), and the progression of AVC and CC was determined. Patients were divided into 2 groups according to LDL: group 1, LDLՅ3.36 mmol/L (130 mg/dL), 57 patients; group 2, LDLϾ3.36 mmol/L (130 mg/dL), 47 patients. Mean values for CC were 546Ϯ932 mm 3 in scan 1 and 665Ϯ1085 mm 3 in scan 2 for AVC 324Ϯ796 mm 3 and 404Ϯ1076 mm 3 , respectively. The mean progression of CC was 27Ϯ37% (group 1, 16Ϯ22%; group 2, 39Ϯ46%, PՅ0.001) and of AVC was 25Ϯ38% (group 1, 9Ϯ22%; group 2, 43Ϯ44%, PՅ0.001). Conclusions-Quantification of AVC by EBT permits new insights into the progression of aortic valve sclerosis. We observed a strong influence of LDL cholesterol level on the progression of AVC and CC, suggesting that lipid-lowering therapy may decrease the progression of aortic valve calcification.

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Section: See P 1881mentioning

confidence: 99%

Progression of Aortic Valve Calcification

et al. 2001

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“…Although cardiac CT was initially used to detect and quantify coronary artery calcification, 55,56 its applicability to assess AVC was also demonstrated in early studies. [57][58][59] Currently, multidetector CT scanners are most commonly used because of their lower cost and superior spatial and temporal resolution. 60 In CT scans, calcific deposits are displayed as bright regions within the image, and AVC is quantified by using the Agatston method.…”

Section: Role Of Computed Tomographymentioning

confidence: 99%

“…I když se zpočátku CT srdce používa-lo k detekci a kvantifi kaci kalcifi kace koronárních tepen, 55,56 možnost jejího použití při hodnocení AVC prokázaly i starší studie. [57][58][59] V současnosti se vzhledem k nižším nákladům a jednoznačně nejlepšímu prostorovému a časovému rozlišení nejčastěji používají multidetektorové CT scannery. 60 Na CT scanech se depozita kalcia zobrazují jako světlé oblasti a AVC se kvantifi kuje Agatstonovou metodou, kdy jsou kalcifi kovaná ložiska defi nována jako oblasti s ≥ 3 pixely se zeslabením > 130 Hounsfi eldových jednotek.…”

Section: úLoha Počítačové Tomografi Eunclassified

Accurate Assessment of Aortic Stenosis

et al. 2014

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“…But recently, ultrafast computed tomography has been used in the diagnosis of aortic valve stenosis and assessment of its severity in a small number of patients [39,40]. But recently, ultrafast computed tomography has been used in the diagnosis of aortic valve stenosis and assessment of its severity in a small number of patients [39,40].…”

Section: Resultsmentioning

confidence: 99%

Aortic valvuloplasty of calcific aortic stenosis with monofoil and trefoil balloon catheters: practical considerations

et al. 1990

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In order to evaluate the relation between balloon design (monofoil, trefoil) and valvular configuration, experimental aortic valvuloplasty was performed in four post-mortem hearts with calcific aortic stenosis of various morphology. The degree of obstruction of the aortic orifice was assessed by computed axial tomography during inflation of monofoil 15 and 19 mm and trefoil 3 x 12 mm balloon catheters. We also evaluated the hemodynamic repercussion of balloon inflation (fall in systolic aortic pressure) in four elderly patients with acquired aortic stenosis who underwent a percutaneous transluminal aortic balloon valvuloplasty, with stepwise increasing balloon sizes of 15 mm, 19 mm and 3 x 12 mm, as during our in vitro experiments, and who underwent aortic valve replacement later on. In these patients, we correlated the anatomy of the excised aortic valves with the retrospective analysis of aortic pressure curves recorded during previous valvuloplasty procedures. Our experimental and clinicopathological observations showed that the degree of obstruction of the aortic orifice in post-mortem specimens and the tolerance to balloon inflation in live patients are dependent of the valvular configuration. Although trefoil balloons have the theoretical advantage to avoid complete obstruction of the aortic orifice during inflation, we observed that in presence of a tricuspid configuration, they could be potentially more occlusive than monofoil balloons since each of the 3 individual components of the trefoil balloon occupied the intercommissural spaces while inflated. However, they offered more residual free space when inflated in aortic valves with a bicuspid configuration (i.e. congenitally bicuspid valves or tricuspid valves with one fused commissure). In our opinion, these observations are relevant, since degenerative disease of the aortic valve (i.e. tricuspid valve without commissural fusion) is now recognized as the most common etiology of aortic stenosis in the elderly.

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Preliminary experience in the use of ultrafast computed tomography to diagnose aortic valve stenosis

Cited by 17 publications

References 21 publications

Progression of Aortic Valve Calcification

Progression of Aortic Valve Calcification

Accurate Assessment of Aortic Stenosis

Aortic valvuloplasty of calcific aortic stenosis with monofoil and trefoil balloon catheters: practical considerations

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