计算机断层扫描的下室间隔厚度预测TAVR术后是否需要植入起搏器。

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2025-09-20 DOI:10.1016/j.ijcard.2025.133915

Manuel Garofalo , Valentina Scheggi , Yohann Bohbot , Jasim Hasan , Pierre Vanhaecke , Emilion Hucleux , Giorgia Panichella , Francesco Meucci , Ruggero Mazzotta , Samuele Salvi , Lucrezia Biagiotti , Matteo Orlandi , Angela Ilaria Fanizzi , Nicola Zoppetti , Renato Valenti , Matilde Papi , Antonio Fidanzati , Francesca Ciatti , Alessio Mattesini , Miroslava Stolcova , Carlo Di Mario

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引用次数: 0

摘要

背景：经导管主动脉瓣置换术（TAVR）是特定患者重度主动脉瓣狭窄（AS）的标准治疗方法。虽然已知膜间隔长度和tavr前传导障碍是永久性起搏器植入（PPI）的预测因素，但通过术前计算机断层扫描（CT）评估的肌室间隔（IVS）厚度的影响尚不清楚。目的：本研究的目的是评估心脏CT显示的间隔厚度在预测TAVR术后是否需要PPI方面的作用。方法：本回顾性队列研究分析了2019年1月至2022年12月期间接受TAVR的患者。在术前CT扫描上测量收缩期末期间隔膜以下不同水平的IVS厚度。多变量logistic回归模型评估PPI的预测因子，包括IVS厚度。结果：在338例患者中（中位年龄：81 岁；42.6 %为女性），20.1 %在tavr后需要PPI。需要PPI的患者IVS厚度2 mm（3.9 ± 0.8 mm vs. 4.5 ± 1.3 mm, p ）明显降低。结论：术前CT IVS厚度独立预测tavr后PPI，改善风险分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Lower interventricular septal thickness from computed tomography predicts the need for pacemaker implantation after TAVR

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Lower interventricular septal thickness from computed tomography predicts the need for pacemaker implantation after TAVR

Background

Transcatheter aortic valve replacement (TAVR) is the standard treatment for severe aortic stenosis (AS) in select patients. While membranous septum length and pre-TAVR conduction disturbances are known predictors of permanent pacemaker implantation (PPI), the impact of muscular interventricular septal (IVS) thickness, assessed via pre-procedural computed tomography (CT), remains unclear.

Objectives

The aim of the study was to evaluate the role of septal thickness with cardiac CT in predicting the need for PPI after TAVR.

Methods

This retrospective cohort study analyzed patients undergoing TAVR between January 2019 and December 2022. IVS thickness was measured in end-systole at various levels below the membranous septum on pre-procedural CT scans. Multivariable logistic regression models assessed predictors of PPI, including IVS thickness.

Results

Among the 338 patients (median age: 81 years; 42.6 % women), 20.1 % required PPI post-TAVR. Patients needing PPI had significantly lower IVS thickness 2 mm (3.9 ± 0.8 mm vs. 4.5 ± 1.3 mm, p < 0.001), 5 mm (5.9 ± 1.1 mm vs. 6.8 ± 1.8 mm, p < 0.001), and 10 mm (9.3 ± 1.1 mm vs. 10.6 ± 2.3 mm, p < 0.001) below the membranous septum. Multivariable analysis identified IVS thickness at 10 mm (HR: 0.73, 95 % CI: 0.56–0.96, p = 0.023), membranous septum length (HR: 0.79, 95 % CI: 0.67–0.94, p = 0.007), and right bundle branch block (HR: 7.70, 95 % CI: 3.70–15.90, p < 0.001) as independent predictors of PPI.

Conclusions

IVS thickness on pre-procedural CT independently predicts PPI post-TAVR and improves risk stratification.

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来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.