Ren Xinshuang, Zhang Minghui, Liu Kun, Hou Zhihui, Gao Yang, Yin Weihua, Wang Zhiqiang, Li Zhennan, Lu Bin
Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Department of Ultrasound, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Int J Cardiovasc Imaging. 2016 Mar;32(3):471-8. doi: 10.1007/s10554-015-0783-y. Epub 2015 Oct 6.
Bicuspid aortic valve (BAV) is a common congenital heart disease. Our study was to analyze clinical features of BAV and evaluate whether aortic valve calcium score (AVCS) was a reliable marker for aortic stenosis (AS) in patients with BAV. 101 patients with BAV who both underwent echocardiology and cardiac computed tomography (CT) scan in our institution were included. Basic clinical data, haemodynamic feature, aortic valve and coronary calcium score were collected and compared among patients with different valve function and different degree of AS. Risk factors related to severe AS were evaluated by logistic regression, and a receiver operative characteristic curve was used to determine the cutoff calcium score greater than which the diagnosis of severe AS was optimized. Patients with aortic regurgitation (AR) were younger and demonstrated larger aortic annulus and sinus compared with patients with other valve dysfunction. Aortic valve calcium score was higher in patients with AS than with AR. For patients with different degree of AS, there were statistical significances in the value of age, aortic valve calcium score and coronary calcium score. AVCS was positively related to severe AS with an odd ratio of 1.286 (95% CI 1.099-1.504) by every 300 points increase. AVCS was also a strong predictor for severe AS with area under the curve 0.855 with a cutoff value of 897 (sensitivity 86.7%, specificity 72.2%). Conclusively, aortic calcium score calculated by quantitative CT is a reliable marker in evaluating severity of AS.
二叶式主动脉瓣（BAV）是一种常见的先天性心脏病。我们的研究旨在分析BAV的临床特征，并评估主动脉瓣钙化评分（AVCS）是否是BAV患者主动脉狭窄（AS）的可靠标志物。纳入了101例在我院同时接受超声心动图和心脏计算机断层扫描（CT）的BAV患者。收集并比较了不同瓣膜功能和不同AS程度患者的基本临床数据、血流动力学特征、主动脉瓣和冠状动脉钙化评分。通过逻辑回归评估与重度AS相关的危险因素，并使用受试者操作特征曲线确定诊断重度AS的最佳钙化评分临界值。与其他瓣膜功能障碍患者相比，主动脉瓣反流（AR）患者更年轻，主动脉瓣环和主动脉窦更大。AS患者的主动脉瓣钙化评分高于AR患者。对于不同AS程度的患者，年龄、主动脉瓣钙化评分和冠状动脉钙化评分的值存在统计学意义。每增加300分，AVCS与重度AS呈正相关，比值比为1.286（95%CI 1.099-1.504）。AVCS也是重度AS的强预测指标，曲线下面积为0.855，临界值为897（敏感性86.7%，特异性72.2%）。总之，通过定量CT计算的主动脉钙化评分是评估AS严重程度的可靠标志物。
