CT-based evaluation of patient-prosthesis mismatch after transcatheter aortic valve implantation and its influence on outcome.

IF 3.8 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Ramona Schmitt, Nils Ressler, Klaus Kaier, Johannes Brado, Manuel Hein, Martin Soschynski, Dirk Westermann, Franz-Josef Neumann, Philipp Breitbart, Philipp Ruile
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引用次数: 0

Abstract

Background: Patient-prosthesis mismatch (PPM) after trans-catheter aortic valve implantation (TAVI) is a risk factor for heart failure and mortality. Assessment of PPM using transthoracic echocardiography (TTE) and presence of hypo-attenuated leaflet thickening (HALT) may lead to overestimation. Our study aimed to assess the incidence of PPM using TTE and CTA after exclusion of patients with HALT and to evaluate predictors analyzing stent geometry.

Methods: 444 patients were analyzed. PPM was calculated using the continuity equation from TTE (TTE-PPM) and CTA (CT-PPM). Regression analyses were conducted for the endpoint effective orifice area (EOA) as surrogate for PPM.

Results: Severe PPM was detected in 4.5% using TTE-PPM and in 0.5% using CT-PPM. Body mass index (BMI) was identified as a predictor for a smaller EOA in each model (p < 0.001). Using TTE-PPM and CT-PPM, a smaller valve diameter was associated with a smaller effective orifice area (EOA) (p < 0.001). Presence of a balloon-expanding valve was associated with a smaller EOA using CT-PPM (p = 0.033). Stent geometry did not influence the EOA (p > 0.05 each model). EOA did not influence overall survival (p > 0.05 each model).

Conclusions: The incidence of severe PPM was very low and only predicted by BMI in each assessment model. Stent geometry did not influence the incidence of PPM. Overall survival was not influenced by a smaller EOA.

经导管主动脉瓣植入术后患者与假体不匹配的ct评价及其对预后的影响。
背景:经导管主动脉瓣植入术(TAVI)后患者-假体不匹配(PPM)是心力衰竭和死亡率的危险因素。使用经胸超声心动图(TTE)评估PPM和存在低衰减小叶增厚(HALT)可能导致高估。我们的研究目的是在排除HALT患者后使用TTE和CTA评估PPM的发生率,并通过分析支架几何来评估预测因素。方法:对444例患者进行分析。PPM采用TTE (TTE-PPM)和CTA (CT-PPM)的连续性方程计算。终点有效孔口面积(EOA)作为PPM的替代指标进行回归分析。结果:使用te -PPM检测4.5%的严重PPM,使用CT-PPM检测0.5%的严重PPM。在每个模型中,体重指数(BMI)被确定为较小的EOA的预测因子(每个模型p 0.05)。EOA对总生存率无影响(各模型p < 0.05)。结论:各评价模型中重度PPM的发生率均很低,仅能通过BMI预测。支架的几何形状不影响PPM的发生率。总生存率不受较小的EOA的影响。
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
Clinical Research in Cardiology
Clinical Research in Cardiology 医学-心血管系统
CiteScore
11.40
自引率
4.00%
发文量
140
审稿时长
4-8 weeks
期刊介绍: Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.
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