The first-line evaluation of aortic stenosis severity is Doppler echocardiography. However, in ≤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 into clinical practice.

Editors

Editor-in-Chief
Y.S. Chandrashekhar, MD, DM, FACC

CME Editor
Ragavendra R. Baliga, MD

Author
Marie-Annick Clavel, DVM, PhD

CME/MOC/ECME Information

Target Audience

JACC Journal CME/MOC is intended for physicians who treat patients with cardiovascular disease.

Important Dates

Date of Release: September 2, 2019
Term of Approval/Date of CME/MOC/ECME Expiration: September 1, 2020