Influence of aortic valve leaflet calcification on dynamic aortic valve motion assessed by cardiac computed tomography

BackgroundComputed tomography is the best noninvasive imaging modality for evaluating valve leaflet calcification.ObjectiveTo evaluate the association of aortic valve leaflet calcification with instantaneous valve opening and closing using dynamic multidetector computed tomography (MDCT).MethodsWe retrospectively evaluated 58 consecutive patients who underwent dynamic MDCT imaging. Aortic valve calcification (AVC) was quantified using the Agatston method. The aortic valve area (AVA) tracking curves were derived by planimetry during the cardiac cycle using all 20 phases (5% reconstruction). da/dt in cm2/s was calculated as the rate of change of AVA during opening (positive) or closing (negative). Patients were divided into 3 three groups according to Agatston score quartile: no AVC (Q2, Score 0, n = 18), mild AVC (Q3, Score 1-2254, n = 24), and severe AVC (Q4 Score >2254, n = 14).ResultsIn multivariable linear regression, compared to the non AVC group, the mild and severe AVC groups had lower maximum AVA (by −1.71 cm2 and −2.25 cm2, respectively), lower peak positive da/dt (by −21.88 cm2/s and −26.65 cm2/s, respectively), and higher peak negative da/dt (by 13.78 cm2/s and 18.11 cm2/s, respectively) (p < 0.05 for all comparisons).ConclusionsAVA and its opening and closing were influenced by leaflet calcification. The present study demonstrates the ability of dynamic MDCT imaging to assess quantitative aortic valve motion in a clinical setting.