Background and aim of the study: Aortic stenosis (AS) is a common clinical problem which frequently necessitates aortic valve replacement (AVR). The traditional view of progressive AS is a 1:1 inverse relationship between valve calcium content and aortic valve area (AVA). However, this assumption has been based on subjective estimates of calcification on chest X-radiographic images. The study aim was to evaluate the relationship between AVA as measured with echocardiography compared to calcium quantification using electron beam computed tomography (EBT).
Methods: Sixty-one patients with an AVA between 0.7 and 2.0 cm2 underwent an EBT scan to evaluate the aortic valve calcium content.

Results: The mean (± SD) aortic valve Agatston calcium score was 1,458.4 ± 1,362.2, and for the aortic valve volume score was 1,178.8 ± 1,066.0. The aortic valve Agatston score did not correlate strongly with AVA
(r = -0.34, 95% CI -0.54, -0.09; p = 0.007). The data
pattern appeared curvilinear, with the poorest correlation noted for those patients with moderate and severe aortic valve calcification.
Conclusion: The study findings support the hypothesis that the aortic valve orifice area decreases not only due to calcium accumulation but also to sclerotic processes.
The Journal of Heart Valve Disease 2006;15:322-328