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主动脉瓣钙化评分:在临床实践与科研中的应用——一篇叙述性综述

Aortic Valve Calcium Score: Applications in Clinical Practice and Scientific Research-A Narrative Review.

作者信息

Gać Paweł, Jaworski Arkadiusz, Grajnert Filip, Kicman Katarzyna, Trejtowicz-Sutor Agnieszka, Witkowski Konrad, Poręba Małgorzata, Poręba Rafał

机构信息

Centre of Diagnostic Imaging, 4th Military Hospital, Rudolfa Weigla 5, 50-981 Wrocław, Poland.

Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, J. Mikulicza-Radeckiego 7, 50-345 Wrocław, Poland.

出版信息

J Clin Med. 2024 Jul 11;13(14):4064. doi: 10.3390/jcm13144064.


DOI:10.3390/jcm13144064
PMID:39064103
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11277735/
Abstract

In this narrative review, we investigate the essential role played by the computed tomography Aortic Valve Calcium Score (AVCS) in the cardiovascular diagnostic landscape, with a special focus on its implications for clinical practice and scientific research. Calcific aortic valve stenosis is the most prevalent type of aortic stenosis (AS) in industrialized countries, and due to the aging population, its prevalence is increasing. While transthoracic echocardiography (TTE) remains the gold standard, AVCS stands out as an essential complementary tool in evaluating patients with AS. The advantage of AVCS is its independence from flow; this allows for a more precise evaluation of patients with discordant findings in TTE. Further clinical applications of AVCS include in the assessment of patients before transcatheter aortic valve replacement (TAVR), as it helps in predicting outcomes and provides prognostic information post-TAVR. Additionally, we describe different AVCS thresholds regarding gender and the anatomical variations of the aortic valve. Finally, we discuss various scientific studies where AVCS was applied. As AVCS has some limitations, due to the pathophysiologies of AS extending beyond calcification and gender differences, scientists strive to validate contrast-enhanced AVCS. Furthermore, research on developing radiation-free methods of measuring calcium content is ongoing.

摘要

在这篇叙述性综述中,我们探讨了计算机断层扫描主动脉瓣钙化评分(AVCS)在心血管诊断领域所起的重要作用,特别关注其对临床实践和科学研究的影响。钙化性主动脉瓣狭窄是工业化国家中最常见的主动脉狭窄(AS)类型,并且由于人口老龄化,其患病率正在上升。虽然经胸超声心动图(TTE)仍然是金标准,但AVCS作为评估AS患者的重要辅助工具脱颖而出。AVCS的优势在于其不受血流影响;这使得能够更精确地评估TTE检查结果不一致的患者。AVCS的进一步临床应用包括在经导管主动脉瓣置换术(TAVR)前对患者进行评估,因为它有助于预测预后并提供TAVR后的预后信息。此外,我们描述了关于性别和主动脉瓣解剖变异的不同AVCS阈值。最后,我们讨论了应用AVCS的各种科学研究。由于AS的病理生理学超出了钙化范围且存在性别差异,AVCS存在一些局限性,因此科学家们致力于验证对比增强AVCS。此外,关于开发无辐射测量钙含量方法的研究正在进行中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b7/11277735/0aae127a28e8/jcm-13-04064-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b7/11277735/728cc78fa5d8/jcm-13-04064-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b7/11277735/7c2a7c7fb25d/jcm-13-04064-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b7/11277735/1f932ef89c0f/jcm-13-04064-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b7/11277735/0aae127a28e8/jcm-13-04064-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b7/11277735/728cc78fa5d8/jcm-13-04064-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b7/11277735/7c2a7c7fb25d/jcm-13-04064-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b7/11277735/1f932ef89c0f/jcm-13-04064-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58b7/11277735/0aae127a28e8/jcm-13-04064-g004.jpg

相似文献

[1]
Aortic Valve Calcium Score: Applications in Clinical Practice and Scientific Research-A Narrative Review.

J Clin Med. 2024-7-11

[2]
Identifying fragile calcifications of the aortic valve in transcatheter aortic valve replacement: iodine concentration of aortic valvular calcification by spectral CT.

Eur Radiol. 2023-3

[3]
Doppler Mean Gradient Is Discordant to Aortic Valve Calcium Scores in Patients with Atrial Fibrillation Undergoing Transcatheter Aortic Valve Replacement.

J Am Soc Echocardiogr. 2022-1

[4]
Severe aortic stenosis with low aortic valve calcification: characteristics and outcome following transcatheter aortic valve implantation.

Eur Heart J Cardiovasc Imaging. 2017-6-1

[5]
Impact of aortic valve calcification severity on device success after transcatheter aortic valve replacement.

Int J Cardiovasc Imaging. 2020-1-8

[6]
Sex Differences in the Impact of Aortic Valve Calcium Score on Mortality After Transcatheter Aortic Valve Replacement.

Circ Cardiovasc Imaging. 2022-8

[7]
Association between aortic valvular calcification and characteristics of the aortic valve in patients with bicuspid aortic valve stenosis.

Acta Radiol. 2019-4

[8]
Regional assessment of aortic valve calcification using topographic maps in contrast-enhanced CT: sex and severity-based differences in calcific presentation.

Quant Imaging Med Surg. 2024-1-3

[9]
Preoperative quantification of aortic valve stenosis: comparison of 64-slice computed tomography with transesophageal and transthoracic echocardiography and size of implanted prosthesis.

Int J Cardiovasc Imaging. 2011-1-30

[10]
Optimal threshold score of aortic valve calcification for identification of significant aortic stenosis on non-electrocardiographic-gated computed tomography.

Eur Radiol. 2023-2

引用本文的文献

[1]
Increased Left Ventricular Myocardial Extracellular Volume Assessed by Cardiac Computed Tomography as a Consequence of Aortic Stenosis and Coexisting Cardiovascular Risk Factors.

J Clin Med. 2025-6-22

本文引用的文献

[1]
Insights into calcific aortic valve stenosis: a comprehensive overview of the disease and advancing treatment strategies.

Ann Med Surg (Lond). 2024-4-29

[2]
Regional assessment of aortic valve calcification using topographic maps in contrast-enhanced CT: sex and severity-based differences in calcific presentation.

Quant Imaging Med Surg. 2024-1-3

[3]
Value of Post-/Pre-Procedural Aortic Regurgitation Ratio vs. Pre-Procedural Aortic Valve Calcium Score to Predict Moderate to Severe Paravalvular Leak Requiring Post-Dilation after Transcatheter Aortic Valve Implantation.

J Clin Med. 2023-12-17

[4]
Diagnostic Performance of Cardiac CT and Transthoracic Echocardiography for Detection of Surgically Confirmed Bicuspid Aortic Valve: Effect of Calcium Extent and Valve Subtypes.

J Korean Soc Radiol. 2023-11

[5]
Association between Serum Testosterone and Aortic Valve Stenosis: A Prospective Cohort Study.

J Cardiovasc Dev Dis. 2023-11-9

[6]
DLFFNet: A new dynamical local feature fusion network for automatic aortic valve calcification recognition using echocardiography.

Comput Methods Programs Biomed. 2024-1

[7]
Impact of Atrial Fibrillation on the Symptoms and Echocardiographic Evaluation of Patients With Aortic Stenosis.

Am J Cardiol. 2024-1-15

[8]
Research and Prediction of Factors Related to High Degree Atrioventricular Block after TAVI Surgery Based on Logistic Regression Model.

Heart Surg Forum. 2023-10-25

[9]
Computed tomography calcium scoring in aortic stenosis: bicuspid versus tricuspid morphology.

Heart. 2024-3-22

[10]
Cardiovascular Calcifications Are Correlated with Inflammation in Hemodialysis Patients.

Medicina (Kaunas). 2023-10-10

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