Korelasi Antara Calcium Score pada Katup Aorta Berdasarkan Pemeriksaan CT Scan dengan Keparahan Stenosis Katup Aorta Berdasarkan Pemeriksaan Echocardiography

Bernadin Rexy Apriandi Wijaya, Prof. Dr. dr. Lina Choridah, Sp.Rad(K)PRP.; dr. Sri Retna Dwidanarti, Sp. Rad., Subsp.Onk.(K)

2025 | Tesis-Spesialis | S2 Radiologi

Latar Belakang: Aortic stenosis (AS) merupakan penyakit katup jantung tersering yang ditandai oleh kalsifikasi progresif yang membatasi pembukaan katup. Pemeriksaan echocardiography masih menjadi baku emas dalam menilai derajat keparahan AS, namun sering ditemukan ketidaksesuaian antarparameter hemodinamik terutama pada kasus low-flow low-gradient. Computed tomography (CT) jantung menawarkan pendekatan kuantitatif melalui pengukuran aortic valve calcium score (AVCS) yang berpotensi berkorelasi dengan derajat keparahan AS.

Metode: Penelitian ini merupakan penelitian analitik observasional dengan desain cross sectional. Pengambilan data dilakukan secara retrospektif pada 50 pasien aortic stenosis yang menjalani CT jantung non-kontras dan echocardiography di RSUP Dr. Sardjito Yogyakarta periode Januari 2021–September 2025. Nilai AVCS dihitung menggunakan metode Agatston, sedangkan derajat AS ditentukan dari parameter echocardiography. Analisis korelasi antara AVCS dan parameter echocardiography dilakukan dengan uji korelasi Spearman.

Hasil: Median AVCS adalah 3.029,3 Agatston unit (rentang 20,6–7.967,6 AU). Terdapat korelasi negatif sedang antara AVCS dengan Aortic Valve Area (r = –0,478; p < 0 xss=removed xss=removed xss=removed>

Kesimpulan: Terdapat korelasi yang signifikan dengan arah positif antara nilai calcium score katup aorta dengan parameter echocardiography terhadap keparahan AS pada CT jantung non-kontras. Pemeriksaan CT jantung non-kontras dengan kuantifikasi aortic valve calcium score berpotensi menjadi alat bantu objektif untuk menegaskan derajat keparahan aortic stenosis.

Background: Aortic stenosis (AS) is the most common heart valve disease characterized by progressive calcification that limits valve opening. Echocardiography remains the gold standard for assessing the severity of AS, but discrepancies between hemodynamic parameters are common, especially in low-flow, low-gradient cases. Cardiac computed tomography (CT) offers a quantitative approach through measuring the aortic valve calcium score (AVCS), which has the potential to correlate with AS severity.

Methods: This is an observational analytical study with a cross-sectional design. Data were collected retrospectively from 50 patients with aortic stenosis who underwent non-contrast cardiac CT and echocardiography at Dr. Sardjito General Hospital, Yogyakarta, from January 2021 to September 2025. The AVCS score was calculated using the Agatston method, while the degree of AS was determined from echocardiographic parameters. Correlation analysis between AVCS and echocardiographic parameters was performed using the Spearman correlation test.

Results: The median AVCS was 3,029.3 Agatston units (range 20.6–7,967.6 AU). There was a moderate negative correlation between AVCS and Aortic Valve Area (r = –0.478; p < 0 xss=removed xss=removed xss=removed>

Conclusion: There was a significant positive correlation between aortic valve calcium score and echocardiographic parameters and AS severity on non-contrast cardiac CT. Non-contrast cardiac CT examination with quantification of aortic valve calcium score has the potential to be an objective tool to confirm the severity of aortic stenosis.

Kata Kunci : Aortic stenosis, calcium score, echocardiography