The Relationship of Aortic Valve Calcium Score and Glomerular Filtration Rate in Patients with Severe Aortic Stenosis and Chronic Kidney Disease
Conference Proceeding - Restricted Access
Journal of the American College of Cardiology
Background: Patients with chronic kidney disease (CKD) often have vascular and valvular calcification. Aortic valve calcium score (AVCS) can be used to help quantify the severity of aortic stenosis (AS). We sought to assess if AVCS in patients with severe AS correlated with the degree of CKD. Methods: We retrospectively studied patients undergoing transcutaneous aortic valve replacement (TAVR) for severe native AS from 12/2014-12/2020. Patients were categorized into their respective CKD stage based on the mean of five GFR measurements prior to their CT TAVR. AVCS data was also obtained and AVCS was compared in CKD Stage I - V using the Kruskal-Wallis Test in the 27th version of SPSS. Results: 324 patients (Stage I - 23, Stage II - 153, Stage III - 132, Stage IV - 11, Stage V - 5) were included. The median (IQR) mean gradient (MG), aortic valve area (AVA), AVCS, and GFR for the population was 40 (31 - 47) mmHg, 0.67 (0.53 - 0.80) cm2, 2594 (1845 - 3702) AU, and 63 (48 - 77) mL/min, respectively. There was no difference in MG (p = 0.909) or AVA (p = 0.377) based on CKD stage. There was also no significant difference in the AVCS in patients based on their respective CKD stage (figure 1, p = 0.884).Conclusion: CKD does not account for the degree of aortic valve calcification seen in patients with severe AS. This suggests that AVCS is less impacted by the degree of renal dysfunction and true surrogate of stenosis severity. Patients with CKD should have similar thresholds for severe AS by AVCS as those with normal renal function.
Mando R, Abbas AE, Allen O, Renard BM, Gallagher MJ, Shannon FL, et al [Vivacqua A, Hanson I] The relationship of aortic valve calcium score and glomerular filtration rate in patients with severe aortic stenosis and chronic kidney disease. J Am Coll Cardiol. 2022 Mar 8;79(9 Suppl):690.