Electron beam computed tomography for the quantification of aortic valvular calcification

Background and aim of the study: Calcific aortic stenosis is common in the elderly; indeed, 30-60% of patients with mild 'senile' aortic stenosis will progress to severe obstruction. Nonetheless, predictors of progression are incompletely defined, and non-invasive technologies capable of quantifying aortic valve calcium are needed. The reliability of electron beam computed tomography (EBCT) was evaluated for quantification of aortic valve calcium content. Methods: Nineteen patients with and without restrictive valve calcification underwent EBCT scanning. Separate calcium scores, 30 s apart, were obtaine d in all patients, and the Spearman correlation coefficient was calculated between measurements. The relationship between dichotomized mean calcium sc ore and aortic valve area was also investigated. Results: There was excellent correlation between calcium scores (R = 0.99, p = 0.0001), as well as a significant inverse relationship between calcium scores in the upper and lower ranges and aortic valve area (p = 0.002). Conclusion: EBCT can be used for reproducible quantitation of aortic valve calcification. While at their extremes, calcium scores are inversely relate d to aortic valve area, further evaluation is needed to define the precise nature of this relationship throughout the spectrum of stenosis severity. E BCT holds promise in the longitudinal assessment of valvular calcification progression and its response to potential medical therapies.