{"title":"CT-derived Extracellular Volume Fraction in Aortic Stenosis, Cardiac Amyloidosis and Dual Pathology.","authors":"Masafumi Kidoh, Seitaro Oda, Noriaki Tabata, Naoto Kuyama, Tetsuya Oguni, Seiji Takashio, Hidetaka Hayashi, Shinpei Yamaguchi, Takeshi Nakaura, Yasunori Nagayama, Kengo Nakato, Yasuhiro Izumiya, Kenichi Tsujita, Toshinori Hirai","doi":"10.1093/ehjci/jeae320","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To investigate CT-derived extracellular volume fraction (CT-ECV) in patients with lone aortic stenosis (AS), dual pathology of AS and transthyretin cardiac amyloidosis (AS-ATTR), and lone ATTR, and to examine the diagnostic performance and optimal cutoff values of CT-ECV for differentiating between patients with lone AS and AS-ATTR, and between patients with lone AS and lone ATTR.</p><p><strong>Methods and results: </strong>This retrospective study included consecutive patients with severe AS (including lone AS and AS-ATTR) and lone ATTR who underwent CT-ECV analysis and technetium 99m pyrophosphate (99mTc-PYP) scintigraphy. The diagnostic performance of CT-ECV for detecting cardiac amyloidosis was evaluated using the area under the receiver operating characteristic curve (AUC). Of 138 patients (mean age, 80 ± 8; 96 men), 55 had lone AS, 19 had AS-ATTR and 64 had lone ATTR. CT-ECV of patients with lone AS was 31 ± 5%. CT-ECV was significantly lower in patients with AS-ATTR than lone ATTR (45 ± 12% vs 53 ± 13%, P =.04). The AUC for differentiating patients with AS-ATTR from lone AS was lower than for lone ATTR from lone AS (0.90 [95% CI: 0.81, 0.96] vs 0.95 [95% CI: 0.90, 0.98]). The cutoff values of CT-ECV for differentiation between patients with lone AS and AS-ATTR were lower than those between patients with lone AS and lone ATTR (36.6% vs 38.5% [Youden index]). There was no significant difference in the proportion of 99mTc-PYP scintigraphy grade between patients with AS-ATTR and lone-ATTR (P = .20).</p><p><strong>Conclusion: </strong>Despite no significant difference in degree of ATTR between patients with AS-ATTR and lone ATTR, CT-ECV of patients with dual AS-ATTR pathology was significantly lower than that of patients with lone ATTR. The diagnostic performance and optimal cutoff values of CT-ECV for differentiating between patients with lone AS and AS-ATTR were lower than those between patients with lone AS and lone ATTR.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":""},"PeriodicalIF":6.7000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Cardiovascular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjci/jeae320","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: To investigate CT-derived extracellular volume fraction (CT-ECV) in patients with lone aortic stenosis (AS), dual pathology of AS and transthyretin cardiac amyloidosis (AS-ATTR), and lone ATTR, and to examine the diagnostic performance and optimal cutoff values of CT-ECV for differentiating between patients with lone AS and AS-ATTR, and between patients with lone AS and lone ATTR.
Methods and results: This retrospective study included consecutive patients with severe AS (including lone AS and AS-ATTR) and lone ATTR who underwent CT-ECV analysis and technetium 99m pyrophosphate (99mTc-PYP) scintigraphy. The diagnostic performance of CT-ECV for detecting cardiac amyloidosis was evaluated using the area under the receiver operating characteristic curve (AUC). Of 138 patients (mean age, 80 ± 8; 96 men), 55 had lone AS, 19 had AS-ATTR and 64 had lone ATTR. CT-ECV of patients with lone AS was 31 ± 5%. CT-ECV was significantly lower in patients with AS-ATTR than lone ATTR (45 ± 12% vs 53 ± 13%, P =.04). The AUC for differentiating patients with AS-ATTR from lone AS was lower than for lone ATTR from lone AS (0.90 [95% CI: 0.81, 0.96] vs 0.95 [95% CI: 0.90, 0.98]). The cutoff values of CT-ECV for differentiation between patients with lone AS and AS-ATTR were lower than those between patients with lone AS and lone ATTR (36.6% vs 38.5% [Youden index]). There was no significant difference in the proportion of 99mTc-PYP scintigraphy grade between patients with AS-ATTR and lone-ATTR (P = .20).
Conclusion: Despite no significant difference in degree of ATTR between patients with AS-ATTR and lone ATTR, CT-ECV of patients with dual AS-ATTR pathology was significantly lower than that of patients with lone ATTR. The diagnostic performance and optimal cutoff values of CT-ECV for differentiating between patients with lone AS and AS-ATTR were lower than those between patients with lone AS and lone ATTR.
期刊介绍:
European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology.
The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.