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Over the recent years, a number of papers have addressed the use of multislice computed tomography (MS-CT) in patients with aortic stenosis (AS). The ability of the technique to detect and quantify calcifications was the first reason for its application to calcific AS. Indeed, quantification of valvular calcification first by electron-beam tomography1 and later on by MS-CT2,3 has been well validated by studying patients prior to surgery and comparing the results with examinations of the pathological specimen. The methods have been shown to be reasonably accurate although examination may require special care.4 The question is whether this quantification of calcification has any clinical impact. Several studies reported a significant relation between the extent of calcification and the severity of the stenosis as defined by transvalvular gradient, aortic valve area (AVA) or both,3,5–7 whereas other investigators could not find a close association.8 It is obvious that such a relation can only be expected for calcific AS but not for other aetiologies such as congenital or rheumatic. Although some relation would make sense in the calcific form, it is of course highly unlikely that a certain cut-off can allow to distinguish between severe and non-severe AS with reasonable accuracy and that there could be any clinical relevance of quantifying AS by calculating the amount of calcium in an aortic valve. Nevertheless, the increase in calcification reflects the progression of the disease in an individual patient with AS. Therefore, such techniques have been used to study the effect of statines9 and ACE-inhibitors10 on the progression of AS and they certainly will continue to be a valuable tool for research … Corresponding author. E-mail address : helmut.baumgartner{at}meduniwien.ac.at

Is there a role for multislice computed tomography in aortic stenosis?