Incidence and Characteristics of Valve Calcification on Computed Tomography Angiography

Background: Heart valve diseases are common and associated with significant morbidity and mortality, often sharing risk factors with coronary artery disease. Coronary computed tomography angiography (CCTA) is increasingly used to detect incidental valvular calcifications, aiding in diagnosis, risk assessment, and management. Objective: To evaluate the CCTA for incidence of mitral and aortic valvular calcification and their association with cardiovascular prognosis, predictors, and coronary artery disease. Methods: This retrospective study was conducted at the Institute of Cardiology, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan from April 2023 to April 2024. All the patients suspected of angina due to coronary artery disease who underwent the CCTA were included. The CCTA scans of all 534 patients were reviewed to identify the presence of mitral or aortic valve calcification. The primary composite outcomes were mortality by cardiac event, non-fatal myocardial infarction, or stroke. Results: The mean age of patients remained to be 63±6 years. On evaluation of 534 CCTA scans, 75 patients (14%) had aortic valvular calcification and 21 patients (4%) had mitral calcification. Coronary artery calcification was a significant predictor of the composite outcome in patients with both aortic (p =0.025) and mitral valve calcification (p =0.010) on multivariate analysis; however, the presence of valvular calcification alone in either group was not independently associated with the primary composite outcome. Conclusion: Valve calcification is common in CCTA and has an association with coronary artery disease; driven by presence and severity of coronary artery disease but not directly by calcification.