Cowell S J, Newby D E, Burton J, White A, Northridge D B, Boon N A, Reid J
Department of Cardiology, Royal Infirmary, Edinburgh, Scotland, UK.
Clin Radiol. 2003 Sep;58(9):712-6. doi: 10.1016/s0009-9260(03)00184-3.
Incidental aortic valve calcification is often detected during computed tomography. The aim was to compare the severity of valvular stenosis and calcification in patients with aortic stenosis.
One hundred and fifty-seven patients aged 68+/-11 years (range: 34-85) with aortic valve stenosis underwent multislice helical computed tomography and Doppler echocardiography performed by independent, blinded observers. The aortic valve calcium score was determined using automated computer software calibrated with a phantom.
Doppler echocardiography demonstrated a post-valve velocity of 3.45+/-0.66 m/s and a peak gradient of 49+/-11 mmHg. Computed tomography showed excellent reproducibility and the median aortic valve calcium score was 5858 AU (interquartile range, 1555-14,596). The computed tomography aortic valve calcium score positively correlated with the Doppler post-valve velocity and peak gradient (r=0.54, p<0.0001 for both) of the aortic valve. All patients with severe aortic stenosis had a calcium score of >3700 AU.
Calcification of the aortic valve is closely associated with the severity of aortic stenosis, and heavy calcification suggests the presence of severe aortic stenosis that requires urgent cardiological assessment. Patients with lesser degrees of aortic valve calcification should be screened for aortic stenosis and monitored for disease progression.
偶然发现的主动脉瓣钙化常在计算机断层扫描期间被检测到。本研究旨在比较主动脉瓣狭窄患者的瓣膜狭窄和钙化程度。
157例年龄为68±11岁（范围：34 - 85岁）的主动脉瓣狭窄患者接受了多层螺旋计算机断层扫描以及由独立、不知情的观察者进行的多普勒超声心动图检查。使用经体模校准的自动计算机软件确定主动脉瓣钙评分。
多普勒超声心动图显示瓣膜后速度为3.45±0.66 m/s，峰值梯度为49±11 mmHg。计算机断层扫描显示出良好的可重复性，主动脉瓣钙评分中位数为5858 AU（四分位间距，1555 - 14596）。计算机断层扫描主动脉瓣钙评分与主动脉瓣的多普勒瓣膜后速度和峰值梯度呈正相关（两者r = 0.54，p < 0.0001）。所有重度主动脉瓣狭窄患者的钙评分>3700 AU。
主动脉瓣钙化与主动脉瓣狭窄程度密切相关，重度钙化提示存在重度主动脉瓣狭窄，需要紧急进行心脏科评估。主动脉瓣钙化程度较轻的患者应筛查主动脉瓣狭窄并监测疾病进展。
