著者
Yuki Katagiri Kazumasa Yamasaki Noriyuki Hatanaka Hiroki Bota Tomoyuki Tani Tomonori Koga Yuki Setogawa Manabu Misawa Takashi Ueda Seiji Yamazaki
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.4, no.6, pp.274-284, 2022-06-10 (Released:2022-06-10)
参考文献数
28

Background: In patients with aortic stenosis (AS), measurement of aortic valve calcification (AVC) using computed tomography (CT) is recommended in cases where echocardiographic measurements are inconclusive. However, sex-specific AVC thresholds proposed in the guidelines for predicting severe AS (women: 1,200 arbitrary units [AU]; men: 2,000 AU) are based on studies from Western countries.Methods and Results: We retrospectively included 512 Japanese patients with at least moderate AS who underwent transthoracic echocardiography and CT. AVC was quantified using the Agatston method. AVC was positively correlated with peak aortic jet velocity and mean transvalvular gradient (mPG), and negatively correlated with aortic valve area (AVA) and the AVA index (AVAi). In 257 patients with concordant AS grading (152 severe AS [AVAi ≤0.6 cm2/m2, mPG ≥40 mmHg], 105 moderate AS [AVAi >0.6 cm2/m2, mPG <40 mmHg]), receiver operating characteristic curve analysis of AVC predicting severe AS yielded an area under the curve of 0.91 (95% confidence interval [CI] 0.87–0.95; P<0.001) in women and 0.86 (95% CI 0.75–0.98; P<0.001) in men. The optimal thresholds (women: 1,379 AU; men: 1,802 AU) were close to those proposed in the guidelines. The diagnostic accuracy of the thresholds in the guidelines was similar to that of the optimal thresholds.Conclusions: The sex-specific AVC thresholds proposed in international guidelines can be applied to Japanese AS patients, yielding similar diagnostic accuracy as the optimal cut-off derived from the study patients.

言及状況

外部データベース (DOI)

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ガイドラインで推奨される重症大動脈弁狭窄症診断における石灰化スコアの閾値(女性1,200 AU, 男性2,000 AU)は欧米の研究を背景としていますが、日本人での有用性を報告しています。 By 片桐 勇貴 https://t.co/8nJyXDF7CQ #circ_rep https://t.co/WEh0FI0wud
This analysis confirmed the sex-specific AVC thresholds to predict severe AS proposed in the international guidelines (1,200 AU in women and 2,000 AU in men) can be applied to Japanese AS patients. By Yuki Katagiri https://t.co/pj0KxWmOpY #circ_rep https://t.co/Y50k6lNRoj
やっと日の目を見ました。CTでの大動脈弁狭窄症スクリーニングは簡便ですよ! Revisiting the Aortic Valve Calcium Score in Evaluating the Severity of Aortic Stenosis in Japanese Patients ― A Single-Center Study ― https://t.co/J9A9MkOQhA

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