Calcium in the aortic valve. Roentgenologic and hemodynamic correlations in 148 patients.

Abstract

The extent of aortic valvular calcification, graded roentgenologically, was correlated with hemodynamic severity as assessed by cardiac catheterization in 148 patients over age 35 who had aortic valvular disease. Each of 55 patients with extensive calcium seen on roentgenogram had severe aortic valvular disease: 29 had stenosis without significant regurgitation, 25 had stenosis and regurgitation, and 1 had pure regurgitation. Many of the 54 patients with small amounts of calcium seen on roentgenogram or with calcium seen only at fluoroscopy had severe aortic valvular disease, but in 12 of them it was hemodynamically mild. Of 39 patients in whom calcium could not be demonstrated either fluoroscopically or on roentgenograms, 12 had severe aortic regurgitation, but only 1 had severe aortic stenosis. The extent of aortic valvular calcification in general correlated with the peak systolic transvalvular pressure gradient but did not correlate with the degree of aortic regurgitation, and calcium was usually absent in patients with pure regurgitation regardless of its severity. Roentgenologic assessment of aortic valvular calcification provides useful information for evaluating patients suspected of having aortic valvular disease.