Volumen de calcificación de la válvula aórtica y su pronóstico en pacientes sometidos a implante percutáneo de válvula aórtica

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia Pub Date : 2024-11-26 DOI:10.1016/j.recesp.2024.10.003

Héctor A. Álvarez-Covarrubias , Niklas Altaner , Rafael Adolf , Martin Jurisic , Elisabeth Horban , Costanza Pellegrini , Charlotte Duesmann , Mark Lachmann , Christian Thilo , Finn Syryca , Markus Klos , N. Patrick Mayr , Tobias Rheude , Matthias Renker , Efstratios I. Charitos , Heribert Schunkert , Adnan Kastrati , Erion Xhepa , Kim Won-Keun , Michael Joner

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Abstract

Introduction and objectives

It is unknown whether aortic valve calcium volume, as measured by contrast-enhanced computed tomography angiography (angio-CT), is associated with mortality in patients undergoing transcatheter aortic valve implantation (TAVI). We aimed to confirm that contrast-enhanced aortic valve calcium correlates with noncontrast-enhanced calcium score and provides useful prognostic information in patients undergoing TAVI.

Methods

This retrospective observational study included patients from 2 high-volume TAVI centers in Germany, all of whom underwent high-quality angio-CT prior to TAVI. Calcium volume in contrast-enhanced angio-CT was calculated using 3 Mensio software (Pie Medical, The Netherlands), while the calcium score from noncontrast-enhanced angio-CT was obtained using the Syngo.via (Siemens Healthineers, Germany) workstation to validate contrast-enhanced angio-CT values. Calcium volume was dichotomized using the median based on to sex-specific values from contrast-enhanced angio-CT, and the risk associated with increased calcium volume was determined using Cox proportional hazard regression analysis.

Results

We included 3318 TAVI patients. A good correlation was observed between noncontrast-enhanced and contrast-enhanced angio-CT (r² = 0.680; P < .001). The median values for sex-specific contrast-enhanced angio-CT calcium volume were 514 mm³ for women and 1025 mm³ for men. Patients with higher calcium volumes showed lower mortality at 1 year (8.8% vs 12.1%; adjusted HR, 0.86; 95%CI, 0.75-0.98; P = .02) compared with those with lower calcium volumes.

Conclusions

Calcium volume in contrast-enhanced angio-CT correlated well with noncontrast-enhanced angio-CT calcium score. Patients with higher calcium volume showed lower mortality at 1 year after TAVI.

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经皮主动脉瓣植入患者主动脉瓣膜钙化量及其预后

目前尚不清楚经导管主动脉瓣植入术（TAVI）患者的主动脉瓣钙容量是否与经导管主动脉瓣植入术（TAVI）患者的死亡率相关。我们的目的是证实对比增强的主动脉瓣钙与非对比增强的钙评分相关，并为TAVI患者提供有用的预后信息。方法本回顾性观察性研究纳入了来自德国2个大容量TAVI中心的患者，所有患者在TAVI之前都接受了高质量的血管ct检查。使用3 Mensio软件（Pie Medical, The Netherlands）计算对比增强血管ct上的钙体积，使用Syngo软件计算非对比增强血管ct上的钙评分。通过（Siemens Healthineers, Germany）工作站验证对比增强血管ct值。使用基于对比增强血管ct的性别特异性值的中位数对钙量进行二分类，并使用Cox比例风险回归分析确定与钙量增加相关的风险。结果纳入TAVI患者3318例。对比增强与非对比增强血管ct之间存在良好的相关性(r2 = 0.680；P & lt;措施)。性别特异性对比增强血管ct钙容量的中位数为女性514 mm3，男性1025 mm3。钙含量较高的患者1年死亡率较低(8.8% vs 12.1%；调整后的HR为0.86；95%置信区间,0.75 - -0.98;P = .02)。结论增强血管ct钙体积与非增强血管ct钙评分相关性较好。高钙容量患者TAVI术后1年死亡率较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista espanola de cardiologia 医学-心血管系统

CiteScore

4.20

自引率

13.60%

发文量

257

审稿时长

28 days

期刊介绍： Revista Española de Cardiología, Revista bilingüe científica internacional, dedicada a las enfermedades cardiovasculares, es la publicación oficial de la Sociedad Española de Cardiología.