Abstract 12696: Association Between Aortic Valve Calcification and Aortic Valve Size in Patients With Severe High Gradient Aortic Stenosis

Abstract

Introduction: It is known that women require less aortic valve calcification (AVC) to develop severe aortic stenosis (AS) than men. Thus, gender specific AVC thresholds for the diagnosis of severe AS are recommended by the ACC/AHA guidelines. However, it is also known that women have smaller hearts and aortic valves (AV) than men. Hypothesis: We hypothesize that AVC is associated with AV size independently from sex. Methods: Consecutive patients with severe high gradient AS who underwent cardiac computed tomography (CT) were included in our study. AV annulus area and AVC assessed with the Agatston score were measured in CT. Linear regression model adjusted for age and sex as well as spearman correlation analysis were performed. Results: 437 patients with severe high gradient AS (mean age 80±6 years, 47% female) were included. Significant differences in AVC (3363 [2582-4398] AU vs. 1984 [1354-2856] AU, p<0.001) and AV annulus area (509 ± 75 mm 2 vs. 408 ± 67 mm 2 , p<0.001) between men and women were found. We observed a significant correlation of AV annulus area with AVC (r=0.6, p<0.001). On multivariate regression AV annulus area was significantly associated with the Agatston score (β=7.5, p<0.001). Furthermore, separate regression analyses for men and women confirmed the significant association of AV annulus area with AVC independent from sex (β (men) =7.0, p<0.001; β (women) =8.2, p<0.001). Conclusions: In patients with severe high gradient AS AV annulus area is associated with AVC independent from sex. Thus, an indexation of AVC thresholds to AV size should be applied rather than using fixed sex-dependent AVC cut-offs for the definition of severe AS.