ArticleJournal of the American Heart Association2026
Aortic Valve Calcium Score Spectrum Identifies Bimodal Outcomes for Transcatheter Aortic Valve Implantation: Insights From the AMTRAC Registry.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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Authors and funding
34 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDegenerative calcification is the primary mechanism underlying severe aortic stenosis; however, some patients with hemodynamically severe aortic stenosis have low aortic valve calcium scores (AVCS), suggesting heterogeneous disease processes. This study aimed to evaluate the clinical characteristics and outcomes across the spectrum of AVCS.
methodsWe performed a retrospective analysis of the AMTRAC (Aortic+Mitral Transcatheter Valve) registry, including 3766 patients with severe aortic stenosis who underwent transcatheter aortic valve implantation across 16 centers mainly in Europe (2013-2024). Patients were stratified into three groups of low, high, or very high based on their AVCS. The primary end point was 3-year mortality. Secondary end points included periprocedural outcomes (Valve Academic Research Consortium-3) and posttranscatheter aortic valve implantation hemodynamics.
resultsPatients with low AVCS more frequently presented with low-gradient aortic stenosis and advanced New York Heart Association classes. At 3 years, mortality displayed a bimodal pattern in association with AVCS spectrum: 30.5% in the low, 26.5% in the high, and 31.3% in the very-high AVCS group (
conclusionsLow AVCS defines a unique phenotype marked by predominant fibrosis, advanced symptoms, and increased mortality despite fewer procedural complications. In contrast, very-high AVCS is linked to higher procedural risk, more bicuspid valves, and increased mortality. These insights challenge calcification-based criteria and support incorporating fibrosis assessment into treatment strategies.
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