{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:35:38Z","timestamp":1790868938319,"version":"4.1.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004963","name":"European Union Seventh Framework Program","doi-asserted-by":"publisher","award":["FP7\/2007\/2013"],"award-info":[{"award-number":["FP7\/2007\/2013"]}],"id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Inserm Translational"},{"DOI":"10.13039\/501100013414","name":"R\u00e9gion Pays de la Loire","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013414","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Nantes M\u00e9tropole"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Aortic valve calcification (AVC) of surgical valve bioprostheses (BPs) has been poorly explored. We aimed to evaluate in vivo and ex vivo BP AVCs and its prognosis value.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Between 2011 and 2019, AVC was assessed using in vivo computed tomography (CT) in 361 patients who had undergone surgical valve replacement 6.4 \u00b1 4.3 years earlier. Ex vivo CT scans were performed for 37 explanted BPs. The in vivo CT scans were interpretable for 342 patients (19 patients [5.2%] were excluded). These patients were 77.2 \u00b1 9.1 years old, and 64.3% were male. Mean in vivo AVC was 307 \u00b1 500\u2005Agatston\u2005units (AU). The AVC was 562 \u00b1 570\u2005AU for the 183 (53.5%) patients with structural valve degeneration (SVD) and 13 \u00b1 43\u2005AU for those without SVD (P &amp;lt; 0.0001). In vivo and ex vivo AVCs were strongly correlated (r = 0.88, P &amp;lt; 0.0001). An in vivo AVC &amp;gt; 100\u2005AU (n = 147, 43%) had a specificity of 96% for diagnosing Stage 2\u20133 SVD (area under the curve = 0.92). Patients with AVC &amp;gt; 100\u2005AU had a worse outcome compared with those with AVC \u2264 100\u2005AU (n = 195). In multivariable analysis, AVC was a predictor of overall mortality (hazard ratio [HR] and 95% confidence interval = 1.16 [1.04\u20131.29]; P = 0.006), cardiovascular mortality (HR = 1.22 [1.04\u20131.43]; P = 0.013), cardiovascular events (HR = 1.28 [1.16\u20131.41]; P &amp;lt; 0.0001), and re-intervention (HR = 1.15 [1.06\u20131.25]; P &amp;lt; 0.0001). After adjustment for Stage 2\u20133 SVD diagnosis, AVC remained a predictor of overall mortality (HR = 1.20 [1.04\u20131.39]; P = 0.015) and cardiovascular events (HR = 1.25 [1.09\u20131.43]; P = 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>CT scan is a reliable tool to assess BP leaflet calcification. An AVC &amp;gt; 100\u2005AU is tightly associated with SVD and it is a strong predictor of overall mortality and cardiovascular events.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeae100","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T12:37:15Z","timestamp":1712925435000},"page":"1226-1234","source":"Crossref","is-referenced-by-count":2,"title":["Calcification of surgical aortic bioprostheses and its impact on clinical outcome"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5864-0348","authenticated-orcid":false,"given":"Guillaume","family":"Guimbreti\u00e8re","sequence":"first","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"},{"name":"L\u2019institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"S\u00e9nage","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"},{"name":"INSERM UMR 1246\u2014SPHERE, Nantes University, Tours University , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sophie","family":"Boureau","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"},{"name":"L\u2019institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Charles","family":"Roos","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Bernard","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baptiste","family":"Carlier","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Veziers","sequence":"additional","affiliation":[{"name":"INSERM, UMR 1229, RMeS, CHU Nantes, PHU4 OTONN, UNIV Nantes , Nantes , France"},{"name":"UFR Odontologie, SC3M Plateform, UMS INSERM 016\u2014CNRS 3556, SFR Fran\u00e7ois Bonamy , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Cueff","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"},{"name":"L\u2019institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Piriou","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"},{"name":"L\u2019institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guenola","family":"Coste","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imen","family":"Fellah","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"},{"name":"L\u2019institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coline","family":"Lelarge","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karine","family":"Warin-Fresse","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-8897","authenticated-orcid":false,"given":"Patrice","family":"Gu\u00e9rin","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"},{"name":"L\u2019institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Costa","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Transplantation Division, Bellvitge Biomedical Research Institute (IDIBELL) and Bellvitge University Hospital-ICS, L\u2019Hospitalet de Llobregat , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Vadori","sequence":"additional","affiliation":[{"name":"Transplant Immunology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital , Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Galina\u00f1es","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Reparative Therapy of the Heart, Vall d'Hebron Research Institute (VHIR), University Hospital Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Manez","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Transplantation Division, Bellvitge Biomedical Research Institute (IDIBELL) and Bellvitge University Hospital-ICS, L\u2019Hospitalet de Llobregat , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Soulillou","sequence":"additional","affiliation":[{"name":"INSERM, UMR 1064, ITUN, CHU Nantes, Nantes, France; UNIV Nantes, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Cozzi","sequence":"additional","affiliation":[{"name":"Transplant Immunology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital , Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vered","family":"Padler-Karavani","sequence":"additional","affiliation":[{"name":"Department of Cell Research and Immunology, The Shmunis School of Biomedicine and Cancer Research, The George S. Wise Faculty of Life Sciences, Tel Aviv University , Tel Aviv 69978 , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Serfaty","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"},{"name":"L\u2019institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3928-6977","authenticated-orcid":false,"given":"Jean-Christian","family":"Roussel","sequence":"additional","affiliation":[{"name":"L\u2019institut du thorax, CHU Nantes , 44093 Nantes , France"},{"name":"L\u2019institut du thorax, INSERM UMR 1087, CNRS, UNIV Nantes , Nantes , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0110-9054","authenticated-orcid":false,"given":"Thierry","family":"Le Tourneau","sequence":"additional","affiliation":[{"name":"L\u2019institut du 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