Indexed Aortic Valve Calcium Volume by Computed Tomography Angiography in Patients With Aortic Stenosis: Results of an International Multicenter Cohort Study (JIMG February 2026)-Article: Indexed Aortic Valve Calcium Volume by Computed Tomography Angiography in Patients With Aortic Stenosis: Results of an International Multicenter Cohort Study

Article: Indexed Aortic Valve Calcium Volume by Computed Tomography Angiography in Patients With Aortic Stenosis: Results of an International Multicenter Cohort Study

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This international multicenter retrospective study evaluated whether aortic valve calcium volume measured from contrast-enhanced CT angiography (CTA) can diagnose and risk-stratify aortic stenosis without needing a separate noncontrast CT scan. The cohort included 1,521 patients with mild to severe aortic stenosis from 14 centers, with concurrent echocardiography and CTA.<br /><br />Indexed aortic valve calcium volume correlated strongly with both echocardiographic severity and standard noncontrast CT calcium score. In the derivation cohort, sex-specific thresholds for severe aortic stenosis were identified: 122 mm³/cm² for men and 61 mm³/cm² for women. These thresholds showed excellent diagnostic accuracy and were validated in an independent cohort with similarly high performance.<br /><br />The technique was highly reproducible, with excellent intraobserver and interobserver agreement. In 711 patients with follow-up data, 249 experienced the primary outcome of aortic valve replacement or death over a median of 26 months. Higher indexed calcium volume was independently associated with worse outcomes in the full cohort and in the subgroup with discordant echocardiographic findings. This prognostic association was consistent across sexes.<br /><br />The study suggests that CTA-derived indexed aortic valve calcium volume is a practical, accurate, and prognostically meaningful alternative to traditional noncontrast CT calcium scoring. Because CTA is already routinely performed for transcatheter aortic valve replacement planning and coronary assessment, this approach could streamline evaluation, reduce radiation exposure, and improve management of patients with aortic stenosis, especially when echocardiographic findings are discordant.

Meta Tag

Concept Aortic Valve Calcification

Concept Indexed Calcium Volume

Concept Aortic Stenosis

Concept Severe Aortic Stenosis

Concept Computed Tomography Angiography

Keywords

aortic stenosis

aortic valve calcium

contrast-enhanced CT angiography

CTA

calcium volume

risk stratification

echocardiography

severe aortic stenosis

transcatheter aortic valve replacement

prognostic outcomes

Aortic Valve Calcification

Indexed Calcium Volume

Aortic Stenosis

Severe Aortic Stenosis

Computed Tomography Angiography