Characterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort
Bibliographic record
Abstract
BACKGROUND: Aortic stenosis (AS) involves calcific and fibrotic degeneration of the valve tissue. The only noninvasive method for evaluating both processes is contrast-enhanced computed tomography angiography. We aimed to explore the differences in aortic valve (AV) tissue composition across sex, race/ethnicity, and AS hemodynamic phenotype in US patients referred for transcatheter AV replacement planning. METHODS: We retrospectively analyzed symptomatic patients with AS who underwent computed tomography angiography for transcatheter AV replacement planning between 2015 and 2022. Using semi-automated software, we quantified the AV tissue composition by fibrotic, calcific, and fibro-calcific volumes, and the fibro-calcific ratio (fibrotic/calcific volume) as a measure of valve phenotype. RESULTS: The study included 651 patients (mean age 84 years; 55% women) with 38% non-Hispanic (NH)-White, 27% Hispanic, and 13% NH-Black. Women had lower fibro-calcific (230 versus 293 mm³/cm²; P <0.001) and calcific volumes (85 versus 149 mm³/cm²; P <0.001), and higher fibro-calcific ratio (1.47 versus 0.83; P <0.001). No differences were observed in the fibrotic volumes ( P =0.805). NH-White women had higher fibro-calcific (256 mm³/cm², P =0.002) and fibrotic volumes (145 mm³/cm²; P <0.001), and fibro-calcific ratio (1.57; P =0.01) compared with Hispanic and NH-Black women. No differences were found among men. High-gradient AS had higher fibro-calcific (295 versus 219 mm 3 /cm 2 ; P <0.001) and calcific volumes (148 versus 88 mm 3 /cm 2 ; P <0.001), and a lower fibro-calcific ratio (0.90 versus 1.45; P <0.001), although no difference in fibrotic volume ( P =0.099) compared with low-gradient AS. CONCLUSIONS: Phenotypic differences in computed tomography angiography valve tissue composition exist in patients with AS referred for transcatheter AV replacement, with women and low-gradient AS showing a proportionally more fibrotic phenotype. NH-White women have the highest fibrotic tissue composition, and no differences are evident among men.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.004 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".