ArticleEuropean heart journal. Cardiovascular Imaging2025
Association of aortic valve size with the degree of aortic valve calcification in severe high-gradient aortic stenosis.
Article in European heart journal. Cardiovascular Imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Pacemaker Status and 5-Year Mortality After TAVI: A Sex-Specific Analysis.European journal of clinical investigation · 2026Article
- Assessment of Potential Predictors of Aortic Stenosis Severity Using ECG-Gated Multidetector CT in Patients with Bicuspid and Tricuspid Aortic Valves Prior to TAVI.Journal of clinical medicine · 2026Article
- Calcific Aortic Valve Disease Assessment: Strengths and Challenges.Echocardiography (Mount Kisco, N.Y.) · 2025Article
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Authors and funding
13 authors.
Funding
Abstract
aimsLess pronounced calcification of the aortic valve (AVC) was observed in women with aortic stenosis (AS) when compared with men. Since women have smaller aortic valves (AVs), this could explain a lower calcium load. We aimed to analyse the association of AV size with AVC independent from sex. METHODS AND
resultsConsecutive patients with high-gradient AS, who underwent cardiac computed tomography (CT), were assessed. AV annulus area and AVC with the Agatston score were measured on CT. In total, 601 patients (mean age 80 ± 7 years, 45% female) were included. Women had smaller AV annulus areas (4.12 ± 0.67 vs. 5.15 ± 0.78 cm2, P < 0.001) and lower Agatston scores [2018 (1456-3017) vs. 3394 (2562-4530), P < 0.001] than men. We found a significant correlation (r = 0.594, P < 0.001) and independent association (β = 926.20, P < 0.001) of AV annulus area with AVC. On separate regression analyses for men and women, AVC was independently associated with AV annulus area in both sexes (βmen = 887.77; βwomen = 863.48, both P < 0.001). When patients were stratified into AV size quartiles, patients in the lower quartiles were more likely to have AVC values below recommended sex-specific AVC thresholds. In the lowest quartile, 28% of female and 27% of male patients had Agatston scores below 1200 Agatston units (AU) (women) and 2000 AU (men), while this proportion decreased to 6 and 2%, respectively, in the quartiles with the largest annulus areas.
conclusionIn high-gradient AS, AVC strongly depends on AV annulus area. This association is not dependent on sex. Thus, AVC should be indexed to AV size in addition to sex.
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