{"title":"经导管主动脉瓣置换术患者基于计算机断层扫描的冠状动脉腔容积与心肌质量比：一种新的风险评估方法。","authors":"Wenting Li, Ruichen Ren, Qingyuan Zhao, Chengcheng Qi, Zhiyu Chen, Yang Zhang","doi":"10.1186/s12872-025-04705-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The coronary lumen volume to myocardial mass (V/M) ratio has been suggested as a quantitative metric of potential imbalance between coronary blood supply and myocardial oxygen demand. This study was designed to assess the prognostic value of the V/M ratio for predicting major adverse cardiovascular events (MACE) in patients undergoing transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods: </strong>This study enrolled patients who received a standard planning computed tomography (CT) scan before TAVR and dichotomized at the median of 33.31 mm³/g of V/M ratio into groups with low V/M ratio and high V/M ratio. The V/M ratio was calculated by coronary computed tomography angiography (CTA). The endpoint was a composite of all-cause mortality, stroke, and hospitalization for heart failure. The cumulative incidence of the MACE was compared using Kaplan-Meyer plots and uni- and multivariate Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>In total, 139 patients were enrolled in this study finally (mean age 71.7 ± 6.7 years, 41.7% female). The mean V/M ratio was considerably lower in patients with MACE than in those without MACE (26.5 ± 4.9mm<sup>3</sup>/g vs. 34.0 ± 3.8mm<sup>3</sup>/g, P<0.001). Multivariate Cox proportional hazards regression showed that the low V/M ratio group (≤ 33.31 mm³/g) had a higher risk of MACE after TAVR (HR: 6.14, 95%CI: 1.37-27.54; P = 0.018).</p><p><strong>Conclusions: </strong>The lower V/M ratio could serve as an independent predictor of MACE in patients undergoing TAVR.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"311"},"PeriodicalIF":2.0000,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020294/pdf/","citationCount":"0","resultStr":"{\"title\":\"Computed tomography-based coronary lumen volume to myocardial mass ratio in patients undergoing transcatheter aortic valve replacement: a novel method for risk assessment.\",\"authors\":\"Wenting Li, Ruichen Ren, Qingyuan Zhao, Chengcheng Qi, Zhiyu Chen, Yang Zhang\",\"doi\":\"10.1186/s12872-025-04705-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The coronary lumen volume to myocardial mass (V/M) ratio has been suggested as a quantitative metric of potential imbalance between coronary blood supply and myocardial oxygen demand. This study was designed to assess the prognostic value of the V/M ratio for predicting major adverse cardiovascular events (MACE) in patients undergoing transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods: </strong>This study enrolled patients who received a standard planning computed tomography (CT) scan before TAVR and dichotomized at the median of 33.31 mm³/g of V/M ratio into groups with low V/M ratio and high V/M ratio. The V/M ratio was calculated by coronary computed tomography angiography (CTA). The endpoint was a composite of all-cause mortality, stroke, and hospitalization for heart failure. The cumulative incidence of the MACE was compared using Kaplan-Meyer plots and uni- and multivariate Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>In total, 139 patients were enrolled in this study finally (mean age 71.7 ± 6.7 years, 41.7% female). The mean V/M ratio was considerably lower in patients with MACE than in those without MACE (26.5 ± 4.9mm<sup>3</sup>/g vs. 34.0 ± 3.8mm<sup>3</sup>/g, P<0.001). Multivariate Cox proportional hazards regression showed that the low V/M ratio group (≤ 33.31 mm³/g) had a higher risk of MACE after TAVR (HR: 6.14, 95%CI: 1.37-27.54; P = 0.018).</p><p><strong>Conclusions: </strong>The lower V/M ratio could serve as an independent predictor of MACE in patients undergoing TAVR.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>\",\"PeriodicalId\":9195,\"journal\":{\"name\":\"BMC Cardiovascular Disorders\",\"volume\":\"25 1\",\"pages\":\"311\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-04-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020294/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Cardiovascular Disorders\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12872-025-04705-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Cardiovascular Disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12872-025-04705-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：冠状动脉管腔容积与心肌质量之比（V/M）已被认为是衡量冠状动脉血供和心肌需氧量之间潜在不平衡的定量指标。本研究旨在评估V/M比值在预测经导管主动脉瓣置换术（TAVR）患者主要不良心血管事件（MACE）中的预后价值。方法：本研究将TAVR前接受标准计划CT扫描的患者按中位数33.31 mm³/g V/M比分为低V/M比组和高V/M比组。通过冠状动脉ct血管造影（CTA）计算V/M比值。终点是全因死亡率、中风和因心力衰竭住院的综合数据。采用Kaplan-Meyer图、单因素和多因素Cox比例风险回归分析比较MACE的累积发生率。结果：139例患者最终入组，平均年龄71.7±6.7岁，女性41.7%。MACE患者的平均V/M比明显低于无MACE患者（26.5±4.9mm3/g vs. 34.0±3.8mm3/g）。结论：较低的V/M比可作为TAVR患者MACE的独立预测因子。临床试验号：不适用。
Computed tomography-based coronary lumen volume to myocardial mass ratio in patients undergoing transcatheter aortic valve replacement: a novel method for risk assessment.
Background: The coronary lumen volume to myocardial mass (V/M) ratio has been suggested as a quantitative metric of potential imbalance between coronary blood supply and myocardial oxygen demand. This study was designed to assess the prognostic value of the V/M ratio for predicting major adverse cardiovascular events (MACE) in patients undergoing transcatheter aortic valve replacement (TAVR).
Methods: This study enrolled patients who received a standard planning computed tomography (CT) scan before TAVR and dichotomized at the median of 33.31 mm³/g of V/M ratio into groups with low V/M ratio and high V/M ratio. The V/M ratio was calculated by coronary computed tomography angiography (CTA). The endpoint was a composite of all-cause mortality, stroke, and hospitalization for heart failure. The cumulative incidence of the MACE was compared using Kaplan-Meyer plots and uni- and multivariate Cox proportional hazards regression analysis.
Results: In total, 139 patients were enrolled in this study finally (mean age 71.7 ± 6.7 years, 41.7% female). The mean V/M ratio was considerably lower in patients with MACE than in those without MACE (26.5 ± 4.9mm3/g vs. 34.0 ± 3.8mm3/g, P<0.001). Multivariate Cox proportional hazards regression showed that the low V/M ratio group (≤ 33.31 mm³/g) had a higher risk of MACE after TAVR (HR: 6.14, 95%CI: 1.37-27.54; P = 0.018).
Conclusions: The lower V/M ratio could serve as an independent predictor of MACE in patients undergoing TAVR.
期刊介绍：
BMC Cardiovascular Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the heart and circulatory system, as well as related molecular and cell biology, genetics, pathophysiology, epidemiology, and controlled trials.
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