Gender disparities in aortic stenosis: an optimised assessment using contrast-enhanced computed tomography

Timothy RG Cartlidge, Tania A Pawade, Mhairi K Doris, Jacek Kwiecinski, Audrey C White, Calum D Gray, Philip A Adamson, David E Newby, Marc R Dweck

Research output: Contribution to journalMeeting abstractpeer-review

Abstract / Description of output

Introduction Non-contrast CT aortic valve calcium scoring (AVC) provides assessment of disease severity in aortic stenosis (AS). However, gender differences in the pathogenesis of AS are apparent. Contrast-enhanced CT has the potential to assess both valve calcification and fibrosis but to date has been relatively unexplored.Methods Volunteers (39 mild, 78 moderate, 26 severe AS; 20% female) underwent echocardiography, non-contrast and contrast-enhanced CT. AVC was measured on non-contrast CT. Contrast-enhanced CT was used to quantify volumes of calcium and non-calcific valve thickening (fibrosis).Results Contrast-enhanced CT calcium volumes correlated closely with AVC (r=0.86, p<0.001), and with peak velocity on echocardiography (r=0.57, p<0.001). Clear gender differences were apparent in the contrast-enhanced CT assessment. Males displayed higher calcium volumes than females, even after correction for annulus area (p<0.001). There was a striking difference in the calcium:fibrosis ratio with males having proportionally more calcium than fibrosis and females showing the reverse (males: 1.17 [0.67–2.25] versus females: 0.56 [0.09–1.22], p<0.001). In men, calcium volumes displayed a moderate correlation with peak velocity (r=0.58, p<0.001) whereas in women there was no significant association (r=0.33, p=0.086). Fibrosis volumes demonstrated a weak correlation with peak velocity in men (r=0.26, p=0.006) which was notably stronger in women (r=0.43, p=0.02). A composite fibro-calcific volume provided the strongest correlation with peak velocity in both groups (men: r=0.63, p<0.001; women: r=0.64, p<0.001).Conclusion Contrast-enhanced CT can be used to quantify calcific and fibrotic valve thickening in AS and may be able to address gender discrepancies in the assessment of disease severity.
Original languageEnglish
Pages (from-to)A2
Issue numberSuppl 5
Publication statusPublished - 1 May 2018


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