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Relationship between fractional flow reserve value and the amount of subtended myocardium EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion – an update Physiologic Characteristics and Clinical Outcomes of Patients With Discordance Between FFR and iFR Impact of myocardial supply area on the transstenotic hemodynamics as determined by fractional flow reserve Bosentan therapy in patients with Eisenmenger syndrome: a multicenter, double-blind, randomized, placebo-controlled study Gut microbiota induces high platelet response in patients with ST segment elevation myocardial infarction after ticagrelor treatment Prognostic Implication of Thermodilution Coronary Flow Reserve in Patients Undergoing Fractional Flow Reserve Measurement Predictors of Left Main Coronary Artery Disease in the ISCHEMIA Trial Optical coherence tomography and C-reactive protein in risk stratification of acute coronary syndromes Validation of bifurcation DEFINITION criteria and comparison of stenting strategies in true left main bifurcation lesions

Review ArticleVolume 12, Issue 9, September 2019

JOURNAL:J Am Coll Cardiol. ACC Cardiovasc Imaging. Article Link

Why and How to Measure Aortic Valve Calcification in Patients With Aortic Stenosis

T Pawade, T Sheth, E Guzzetti, MR Dweck et al. Keywords: aortic stenosis;aortic valve calcification; computed tomography

ABSTRACT

The first-line evaluation of aortic stenosis severity is Doppler echocardiography. However, in up to 40% of patients, resting echocardiographic assessment of aortic stenosis severity is discordant, leading to clinical uncertainty. Interest has therefore grown in aortic valve calcium scoring by multidetector computed tomography (CT-AVC) as an alternative load independent assessment of aortic stenosis severity. This paper will briefly review the pathophysiology of aortic stenosis and the crucial role that calcification plays in driving progressive obstruction of the valve. Subsequently, it will describe published reports that have investigated CT-AVC, validating this parameter against histology, and establishing its diagnostic accuracy versus echocardiography as well as its powerful independent prognostic capability. Finally, this review seeks to provide a practical guide about how best to acquire and interpret CT-AVC with a close focus on potential pitfalls and how these might be best avoided as this technique becomes more widely adopted in to clinical practice.