Research progress of methods allowing quantitative analysis of aortic valve calcification_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HUANG Yuming , CHEN Si ,  DONG Nianguo

Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430032, P.R.China;

Corresponding author：

DONG Nianguo, Email: dongnianguo@hotmail.com

Keywords：

Calcification of aortic valve; pathology; medical imageology

DOI：

10.7507/1007-4848.201704010

Video：

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With the development of social economy and medicine, degenerative heart valve disease has become the major part in heart valve disease. Calcific aortic valve disease (CAVD) is one of the most representative manifestations of degenerative valvular disease. Aortic valve calcification (AVC) has been found to be a strong predictor of major cardiovascular events, which makes it necessary to identify an effective way to evaluate the degree of AVC. Numerous methods of quantitative assessment of AVC have been reported. Here, we discuss these methods from the aspects of pathology and imageology.

Citation： HUANG Yuming, CHEN Si, DONG Nianguo. Research progress of methods allowing quantitative analysis of aortic valve calcification. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(10): 900-905. doi: 10.7507/1007-4848.201704010 Copy

1.	Halevi R, Hamdan A, Marom G, et al. Progressive aortic valve calcification: three-dimensional visualization and biomechanical analysis. J Biomech, 2015, 48(3): 489-497.
2.	Flynn AW, Afilalo J, Agnihotri AK, et al. Aortic sclerosis is associated with mortality and major morbidity in patients undergoing coronary artery bypass surgery. Heart, 2013, 99(4): 247-252.
3.	Rosenhek R, Binder T, Porenta G, et al. Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med, 2000, 343(9): 611-617.
4.	Otto CM, Prendergast B. Aortic-valve stenosis——from patients at risk to severe valve obstruction. N Engl J Med, 2014, 371(8): 744-756.
5.	Izquierdo-Gómez MM, Hernández-Betancor I, García-Niebla J, et al. Valve calcification in aortic stenosis: etiology and diagnostic imaging techniques. Biomed Res Int, 2017, 2017: 5178631.
6.	Pasipoularides A. Calcific aortic valve disease: part 1——molecular pathogenetic aspects, hemodynamics, and adaptive feedbacks. J Cardiovasc Transl Res, 2016, 9(2): 102-118.
7.	Zeng YI, Sun R, Li X, et al. Pathophysiology of valvular heart disease. Exp Ther Med, 2016, 11(4): 1184-1188.
8.	Yutzey KE, Demer LL, Body SC, et al. Calcific aortic valve disease: a consensus summary from the Alliance of Investigators on Calcific Aortic Valve Disease. Arterioscler Thromb Vasc Biol, 2014, 34(11): 2387-2393.
9.	Warren BA, Yong JL. Calcification of the aortic valve: its progression and grading. Pathology, 1997, 29(4): 360-368.
10.	Wypasek E, Potaczek DP, Undas A. Association of the C-reactive protein gene (CRP) rs1205 C>T polymorphism with aortic valve calcification in patients with aortic stenosis. Int J Mol Sci, 2015, 16(10): 23745-23759.
11.	Johansson B, Holmgren A, Hedström M, et al. Evaluation of hyaluronan and calcifications in stenotic and regurgitant aortic valves. Eur J Cardiothorac Surg, 2011, 39(1): 27-32.
12.	Palmiero P, Maiello M, Passantino A, et al. Aortic valve sclerosis: is it a cardiovascular risk factor or a cardiac disease marker? Echocardiography, 2007, 24(3): 217-221.
13.	Yousry M, Rickenlund A, Petrini J, et al. Real-time imaging required for optimal echocardiographic assessment of aortic valve calcification. Clin Physiol Funct Imaging, 2012, 32(6): 470-475.
14.	Yousry M, Rickenlund A, Petrini J, et al. Aortic valve type and calcification as assessed by transthoracic and transoesophageal echocardiography. Clin Physiol Funct Imaging, 2015, 35(4): 306-313.
15.	Liu PY, Tsai WC, Lin CC, et al. Invasive measurements of pulse wave velocity correlate with the degree of aortic valve calcification and severity associated with matrix metalloproteinases in elderly patients with aortic valve stenosis. Clin Sci (Lond), 2004, 107(4): 415-422.
16.	Bahler RC, Desser DR, Finkelhor RS, et al. Factors leading to progression of valvular aortic stenosis. Am J Cardiol, 1999, 84(9): 1044-1048.
17.	Agatston AS, Janowitz WR, Hildner FJ, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol, 1990, 15(4): 827-832.
18.	Wang WG, He YF, Chen YL, et al. Proprotein convertase subtilisin/kexin type 9 levels and aortic valve calcification: A prospective, cross sectional study. J Int Med Res, 2016, 44(4): 865-874.
19.	Cueff C, Serfaty JM, Cimadevilla C, et al. Measurement of aortic valve calcification using multislice computed tomography: correlation with haemodynamic severity of aortic stenosis and clinical implication for patients with low ejection fraction. Heart, 2011, 97(9): 721-726.
20.	Jilaihawi H, Makkar RR, Kashif M, et al. A revised methodology for aortic-valvar complex calcium quantification for transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging, 2014, 15(12): 1324-1332.
21.	Minami K, Yoneyama K, Izumo M, et al. Influence of aortic valve leaflet calcification on dynamic aortic valve motion assessed by cardiac computed tomography. J Cardiovasc Comput Tomogr, 2016, 10(6): 485-490.
22.	Regeer MV, Kamperidis V, Versteegh MI, et al. Aortic valve and aortic root features in CT angiography in patients considered for aortic valve repair. J Cardiovasc Comput Tomogr, 2014, 8(4): 299-306.
23.	Masri A, Schoenhagen P, Svensson L, et al. Dynamic characterization of aortic annulus geometry and morphology with multimodality imaging: predictive value for aortic regurgitation after transcatheter aortic valve replacement. J Thorac Cardiovasc Surg, 2014, 147(6): 1847-1854.
24.	Messika-Zeitoun D, Aubry MC, Detaint D, et al. Evaluation and clinical implications of aortic valve calcification measured by electron-beam computed tomography. Circulation, 2004, 110(3): 356-362.
25.	Budoff MJ, Mao S, Takasu J, et al. Reproducibility of electron-beam CT measures of aortic valve calcification. Acad Radiol, 2002, 9(10): 1122-1127.
26.	Kizer JR, Gefter WB, deLemos AS, et al. Electron beam computed tomography for the quantification of aortic valvular calcification. J Heart Valve Dis, 2001, 10(3): 361-366.
27.	Bhattacharyya S, Mittal T, Abayalingam M, et al. Classification of aortic stenosis by flow and gradient patterns provides insights into the pathophysiology of disease. Angiology, 2016, 67(7): 664-669.
28.	Lindman BR, Bonow RO, Otto CM. Current management of calcific aortic stenosis. Circ Res, 2013, 113(2): 223-237.
29.	Mühlenbruch G, Wildberger JE, Koos R, et al. Calcium scoring of aortic valve calcification in aortic valve stenosis with a multislice computed tomography scanner: non-enhanced versus contrast-enhanced studies. Acta Radiol, 2005, 46(6): 561-566.
30.	Clavel MA, Pibarot P, Messika-Zeitoun D, et al. Impact of aortic valve calcification, as measured by MDCT, on survival in patients with aortic stenosis: results of an international registry study. J Am Coll Cardiol, 2014, 64(12): 1202-1213.

1. Halevi R, Hamdan A, Marom G, et al. Progressive aortic valve calcification: three-dimensional visualization and biomechanical analysis. J Biomech, 2015, 48(3): 489-497.
2. Flynn AW, Afilalo J, Agnihotri AK, et al. Aortic sclerosis is associated with mortality and major morbidity in patients undergoing coronary artery bypass surgery. Heart, 2013, 99(4): 247-252.
3. Rosenhek R, Binder T, Porenta G, et al. Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med, 2000, 343(9): 611-617.
4. Otto CM, Prendergast B. Aortic-valve stenosis——from patients at risk to severe valve obstruction. N Engl J Med, 2014, 371(8): 744-756.
5. Izquierdo-Gómez MM, Hernández-Betancor I, García-Niebla J, et al. Valve calcification in aortic stenosis: etiology and diagnostic imaging techniques. Biomed Res Int, 2017, 2017: 5178631.
6. Pasipoularides A. Calcific aortic valve disease: part 1——molecular pathogenetic aspects, hemodynamics, and adaptive feedbacks. J Cardiovasc Transl Res, 2016, 9(2): 102-118.
7. Zeng YI, Sun R, Li X, et al. Pathophysiology of valvular heart disease. Exp Ther Med, 2016, 11(4): 1184-1188.
8. Yutzey KE, Demer LL, Body SC, et al. Calcific aortic valve disease: a consensus summary from the Alliance of Investigators on Calcific Aortic Valve Disease. Arterioscler Thromb Vasc Biol, 2014, 34(11): 2387-2393.
9. Warren BA, Yong JL. Calcification of the aortic valve: its progression and grading. Pathology, 1997, 29(4): 360-368.
10. Wypasek E, Potaczek DP, Undas A. Association of the C-reactive protein gene (CRP) rs1205 C>T polymorphism with aortic valve calcification in patients with aortic stenosis. Int J Mol Sci, 2015, 16(10): 23745-23759.
11. Johansson B, Holmgren A, Hedström M, et al. Evaluation of hyaluronan and calcifications in stenotic and regurgitant aortic valves. Eur J Cardiothorac Surg, 2011, 39(1): 27-32.
12. Palmiero P, Maiello M, Passantino A, et al. Aortic valve sclerosis: is it a cardiovascular risk factor or a cardiac disease marker? Echocardiography, 2007, 24(3): 217-221.
13. Yousry M, Rickenlund A, Petrini J, et al. Real-time imaging required for optimal echocardiographic assessment of aortic valve calcification. Clin Physiol Funct Imaging, 2012, 32(6): 470-475.
14. Yousry M, Rickenlund A, Petrini J, et al. Aortic valve type and calcification as assessed by transthoracic and transoesophageal echocardiography. Clin Physiol Funct Imaging, 2015, 35(4): 306-313.
15. Liu PY, Tsai WC, Lin CC, et al. Invasive measurements of pulse wave velocity correlate with the degree of aortic valve calcification and severity associated with matrix metalloproteinases in elderly patients with aortic valve stenosis. Clin Sci (Lond), 2004, 107(4): 415-422.
16. Bahler RC, Desser DR, Finkelhor RS, et al. Factors leading to progression of valvular aortic stenosis. Am J Cardiol, 1999, 84(9): 1044-1048.
17. Agatston AS, Janowitz WR, Hildner FJ, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol, 1990, 15(4): 827-832.
18. Wang WG, He YF, Chen YL, et al. Proprotein convertase subtilisin/kexin type 9 levels and aortic valve calcification: A prospective, cross sectional study. J Int Med Res, 2016, 44(4): 865-874.
19. Cueff C, Serfaty JM, Cimadevilla C, et al. Measurement of aortic valve calcification using multislice computed tomography: correlation with haemodynamic severity of aortic stenosis and clinical implication for patients with low ejection fraction. Heart, 2011, 97(9): 721-726.
20. Jilaihawi H, Makkar RR, Kashif M, et al. A revised methodology for aortic-valvar complex calcium quantification for transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging, 2014, 15(12): 1324-1332.
21. Minami K, Yoneyama K, Izumo M, et al. Influence of aortic valve leaflet calcification on dynamic aortic valve motion assessed by cardiac computed tomography. J Cardiovasc Comput Tomogr, 2016, 10(6): 485-490.
22. Regeer MV, Kamperidis V, Versteegh MI, et al. Aortic valve and aortic root features in CT angiography in patients considered for aortic valve repair. J Cardiovasc Comput Tomogr, 2014, 8(4): 299-306.
23. Masri A, Schoenhagen P, Svensson L, et al. Dynamic characterization of aortic annulus geometry and morphology with multimodality imaging: predictive value for aortic regurgitation after transcatheter aortic valve replacement. J Thorac Cardiovasc Surg, 2014, 147(6): 1847-1854.
24. Messika-Zeitoun D, Aubry MC, Detaint D, et al. Evaluation and clinical implications of aortic valve calcification measured by electron-beam computed tomography. Circulation, 2004, 110(3): 356-362.
25. Budoff MJ, Mao S, Takasu J, et al. Reproducibility of electron-beam CT measures of aortic valve calcification. Acad Radiol, 2002, 9(10): 1122-1127.
26. Kizer JR, Gefter WB, deLemos AS, et al. Electron beam computed tomography for the quantification of aortic valvular calcification. J Heart Valve Dis, 2001, 10(3): 361-366.
27. Bhattacharyya S, Mittal T, Abayalingam M, et al. Classification of aortic stenosis by flow and gradient patterns provides insights into the pathophysiology of disease. Angiology, 2016, 67(7): 664-669.
28. Lindman BR, Bonow RO, Otto CM. Current management of calcific aortic stenosis. Circ Res, 2013, 113(2): 223-237.
29. Mühlenbruch G, Wildberger JE, Koos R, et al. Calcium scoring of aortic valve calcification in aortic valve stenosis with a multislice computed tomography scanner: non-enhanced versus contrast-enhanced studies. Acta Radiol, 2005, 46(6): 561-566.
30. Clavel MA, Pibarot P, Messika-Zeitoun D, et al. Impact of aortic valve calcification, as measured by MDCT, on survival in patients with aortic stenosis: results of an international registry study. J Am Coll Cardiol, 2014, 64(12): 1202-1213.

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