Lytfi Krasniqi, Christian Juhl Terkelsen, Henrik Nissen, Philip Freeman, Christian Alcaraz Frederiksen, Henrik Vase, Kristian Hejlesen, Christian Byskov Fur, Troels Thim, Ashkan Eftekhari, Frederik Uttenthal, Julia Ellert, Nils Sofus Borg Mogensen, Amal Haujir, Evald Høj Christiansen, Jordi Sanchez Dahl
{"title":"经导管心脏瓣膜中流动状态对有效孔面积的影响：一项比较tavi 1亚研究。","authors":"Lytfi Krasniqi, Christian Juhl Terkelsen, Henrik Nissen, Philip Freeman, Christian Alcaraz Frederiksen, Henrik Vase, Kristian Hejlesen, Christian Byskov Fur, Troels Thim, Ashkan Eftekhari, Frederik Uttenthal, Julia Ellert, Nils Sofus Borg Mogensen, Amal Haujir, Evald Høj Christiansen, Jordi Sanchez Dahl","doi":"10.1016/j.echo.2025.09.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to study the impact of flow-status on Effective Orifice Area (EOA) in patients treated with the balloon-expandable Myval and Sapien transcatheter heart valves (THVs).</p><p><strong>Methods: </strong>We collected the core laboratory measured effective orifice area (EOA), mean and peak gradients, Doppler velocity index (DVI) and stroke volume index (SVi) from the 30-day echocardiograms in patients treated with the balloon-expandable Myval and Sapien THVs in the COMPARE-TAVI 1 trial. Patients were stratified according to flow in low-flow (SVi <35 ml/m<sup>2</sup>) normal-flow (SVi 35-50 ml/m<sup>2</sup>) and high-flow (SVi >50 ml/m<sup>2</sup>).</p><p><strong>Results: </strong>A total of 1031 patients were included in COMPARE-TAVI 1. Myval THVs (20.0mm to 32.0mm) exhibited overall higher mean EOA and lower mean gradients (1.99 ± 0.55 cm<sup>2</sup>, 9.46 ± 3.84 mmHg) compared to Sapien THVs (20-29 mm) (1.81 ± 0.56 cm<sup>2</sup>, 11.47 ± 4.47 mmHg). Compared to normal-flow patients, low-flow exhibited smaller EOA (p<0.001) and lower DVI (p<0.001) in all valve sizes irrespective of THV platform, while high-flow patients had larger EOA (p<0.001) and higher DVI (p<0.001). Female sex was associated with lower stroke volume resulting in lower mean and peak gradients independent of valve size and platform (p<0.001).</p><p><strong>Conclusion: </strong>The study indicates that EOA may be underestimated after TAVI in patients with low-flow status which can impact assessment of prosthesis patient mismatch.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Flow-status on Effective Orifice Area in Transcatheter Heart Valves: a COMPARE-TAVI 1 Substudy.\",\"authors\":\"Lytfi Krasniqi, Christian Juhl Terkelsen, Henrik Nissen, Philip Freeman, Christian Alcaraz Frederiksen, Henrik Vase, Kristian Hejlesen, Christian Byskov Fur, Troels Thim, Ashkan Eftekhari, Frederik Uttenthal, Julia Ellert, Nils Sofus Borg Mogensen, Amal Haujir, Evald Høj Christiansen, Jordi Sanchez Dahl\",\"doi\":\"10.1016/j.echo.2025.09.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The aim of this study was to study the impact of flow-status on Effective Orifice Area (EOA) in patients treated with the balloon-expandable Myval and Sapien transcatheter heart valves (THVs).</p><p><strong>Methods: </strong>We collected the core laboratory measured effective orifice area (EOA), mean and peak gradients, Doppler velocity index (DVI) and stroke volume index (SVi) from the 30-day echocardiograms in patients treated with the balloon-expandable Myval and Sapien THVs in the COMPARE-TAVI 1 trial. Patients were stratified according to flow in low-flow (SVi <35 ml/m<sup>2</sup>) normal-flow (SVi 35-50 ml/m<sup>2</sup>) and high-flow (SVi >50 ml/m<sup>2</sup>).</p><p><strong>Results: </strong>A total of 1031 patients were included in COMPARE-TAVI 1. Myval THVs (20.0mm to 32.0mm) exhibited overall higher mean EOA and lower mean gradients (1.99 ± 0.55 cm<sup>2</sup>, 9.46 ± 3.84 mmHg) compared to Sapien THVs (20-29 mm) (1.81 ± 0.56 cm<sup>2</sup>, 11.47 ± 4.47 mmHg). Compared to normal-flow patients, low-flow exhibited smaller EOA (p<0.001) and lower DVI (p<0.001) in all valve sizes irrespective of THV platform, while high-flow patients had larger EOA (p<0.001) and higher DVI (p<0.001). Female sex was associated with lower stroke volume resulting in lower mean and peak gradients independent of valve size and platform (p<0.001).</p><p><strong>Conclusion: </strong>The study indicates that EOA may be underestimated after TAVI in patients with low-flow status which can impact assessment of prosthesis patient mismatch.</p>\",\"PeriodicalId\":50011,\"journal\":{\"name\":\"Journal of the American Society of Echocardiography\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2025-10-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Society of Echocardiography\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.echo.2025.09.017\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Society of Echocardiography","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.echo.2025.09.017","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Impact of Flow-status on Effective Orifice Area in Transcatheter Heart Valves: a COMPARE-TAVI 1 Substudy.
Objective: The aim of this study was to study the impact of flow-status on Effective Orifice Area (EOA) in patients treated with the balloon-expandable Myval and Sapien transcatheter heart valves (THVs).
Methods: We collected the core laboratory measured effective orifice area (EOA), mean and peak gradients, Doppler velocity index (DVI) and stroke volume index (SVi) from the 30-day echocardiograms in patients treated with the balloon-expandable Myval and Sapien THVs in the COMPARE-TAVI 1 trial. Patients were stratified according to flow in low-flow (SVi <35 ml/m2) normal-flow (SVi 35-50 ml/m2) and high-flow (SVi >50 ml/m2).
Results: A total of 1031 patients were included in COMPARE-TAVI 1. Myval THVs (20.0mm to 32.0mm) exhibited overall higher mean EOA and lower mean gradients (1.99 ± 0.55 cm2, 9.46 ± 3.84 mmHg) compared to Sapien THVs (20-29 mm) (1.81 ± 0.56 cm2, 11.47 ± 4.47 mmHg). Compared to normal-flow patients, low-flow exhibited smaller EOA (p<0.001) and lower DVI (p<0.001) in all valve sizes irrespective of THV platform, while high-flow patients had larger EOA (p<0.001) and higher DVI (p<0.001). Female sex was associated with lower stroke volume resulting in lower mean and peak gradients independent of valve size and platform (p<0.001).
Conclusion: The study indicates that EOA may be underestimated after TAVI in patients with low-flow status which can impact assessment of prosthesis patient mismatch.
期刊介绍：
The Journal of the American Society of Echocardiography(JASE) brings physicians and sonographers peer-reviewed original investigations and state-of-the-art review articles that cover conventional clinical applications of cardiovascular ultrasound, as well as newer techniques with emerging clinical applications. These include three-dimensional echocardiography, strain and strain rate methods for evaluating cardiac mechanics and interventional applications.
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