2026-04-13T04:12:44Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/122222025-10-24T08:53:43Zcom_2072_378070com_2072_378040com_2072_378071col_2072_378092col_2072_378097

00925njm 22002777a 4500 dc Lembo, Maria author Joshi, Shruti Shree author Geers, Jolien author Bing, Rong author Carnevale, Lorenzo author Pawade, Tania A. author Guala, Andrea author Rodríguez Palomares, José F author Ruiz Muñoz, Aroa author Dux-Santoy Hurtado, Lydia author Teixido-Tura, Gisela author Galian-Gay, Laura author 2024-11-14T08:48:52Z 2024-11-14T08:48:52Z 2024-11 Aortic valve stenosis; Fibrocalcific volume; Gaussian mixture model Estenosis de la válvula aórtica; Volumen fibrocalcificado; Modelo de mezcla gaussiana Estenosi de la vàlvula aòrtica; Volum fibrocalcificat; Model de mescla gaussiana Background Aortic stenosis (AS) is characterized by calcification and fibrosis. The ability to quantify these processes simultaneously has been limited with previous imaging methods. Objectives The purpose of this study was to evaluate the aortic valve fibrocalcific volume by computed tomography (CT) angiography in patients with AS, in particular, to assess its reproducibility, association with histology and disease severity, and ability to predict/track progression. Methods In 136 patients with AS, fibrocalcific volume was calculated on CT angiograms at baseline and after 1 year. CT attenuation distributions were analyzed using Gaussian-mixture-modeling to derive thresholds for tissue types enabling the quantification of calcific, noncalcific, and fibrocalcific volumes. Scan-rescan reproducibility was assessed and validation provided against histology and in an external cohort. Results Fibrocalcific volume measurements took 5.8 ± 1.0 min/scan, demonstrating good correlation with ex vivo valve weight (r = 0.51; P < 0.001) and excellent scan-rescan reproducibility (mean difference −1%, limits of agreement −4.5% to 2.8%). Baseline fibrocalcific volumes correlated with mean gradient on echocardiography in both male and female participants (rho = 0.64 and 0.69, respectively; both P < 0.001) and in the external validation cohort (n = 66, rho = 0.58; P < 0.001). The relationship was driven principally by calcific volume in men and fibrotic volume in women. After 1 year, fibrocalcific volume increased by 17% and correlated with progression in mean gradient (rho = 0.32; P = 0.003). Baseline fibrocalcific volume was the strongest predictor of subsequent mean gradient progression, with a particularly strong association in female patients (rho = 0.75; P < 0.001). Conclusions The aortic valve fibrocalcific volume provides an anatomic assessment of AS severity that can track disease progression precisely. It correlates with disease severity and hemodynamic progression in both male and female patients. The SALTIRE 2 trial was funded by the British Heart Foundation (FS/14/78/31020). This work was partially supported by a grant from the Korea Health Technology R and D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant number HI22C0154 to Dr Lee). Dr Joshi has received funding from the British Heart Foundation through a Clinical Research Training Fellowship and Research Excellence Award (FS/CRTF/20/24087 and RE/18/5/34216). Dr Williams is supported by the British Heart Foundation (FS/ICRF/20/26002); and has given talks for Canon Medical Systems, Siemens Healthineers and Novartis. Dr Newby is supported by the British Heart Foundation (CH/09/002, RG/20/10/34966, RE/18/5/34216, CH/F/21/90010); and is the recipient of a Wellcome Trust Senior Investigator Award (WT103782AIA). Dr Dweck is supported by the British Heart Foundation (FS/SCRF/21/32010); is the recipient of the Sir Jules Thorn Award for Biomedical Research 2015 (15/JTA); has received speaker fees from Pfizer, Radcliffe Cardiology, Bristol Myers Squibb, Edwards, and Novartis; has received consultancy fees from Novartis, Jupiter Bioventures, Beren, and Silence therapeutics; and is Director of the Imaging Corelab at the University of Edinburgh. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. http://hdl.handle.net/11351/12222 Fibrosi Calci - Metabolisme - Trastorns Angiografia Vàlvula aòrtica - Estenosi - Imatgeria DISEASES::Cardiovascular Diseases::Heart Diseases::Heart Valve Diseases::Aortic Valve Stenosis Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Image Interpretation, Computer-Assisted::Tomography, X-Ray Computed::Computed Tomography Angiography DISEASES::Nutritional and Metabolic Diseases::Metabolic Diseases::Calcium Metabolism Disorders::Calcinosis DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Fibrosis ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::enfermedades de las válvulas cardíacas::estenosis de la válvula aórtica Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::interpretación de imágenes asistida por ordenador::tomografía computarizada por rayos X::angiografía por tomografía computarizada ENFERMEDADES::enfermedades nutricionales y metabólicas::enfermedades metabólicas::trastornos del metabolismo del calcio::calcinosis ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::fibrosis Quantitative Computed Tomography Angiography for the Evaluation of Valvular Fibrocalcific Volume in Aortic Stenosis