Angiographic assessment of aortic regurgitation by video-densitometry in the setting of TAVI: echocardiographic and clinical correlates
Catheter. cardiovasc. interv
; 90(4): 650-659, 2017. ilus, tab, graf
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1061886
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
We sought to investigate a new angiographic method for aortic regurgitation (AR) severity assessment in the setting of transcatheter aortic valve implantation (TAVI). AR after TAVI is common but challenging to quantitate, especially in the cath-lab. In 228 patients, AR was quantitated before and after TAVI by echocardiography and by video-densitometric analysis of aortograms. Contrast time density curves for the aortic root (the reference region) and the left ventricular outflow tract, LVOT were generated. LVOT-AR was calculated as the area under the curve of the LVOT as a fraction of the area under the curve of the reference region. LVOT-AR was 0.10 6 0.08, 0.13 6 0.10 and 0.28 6 0.14 in none-trace, mild and moderate-severe post-TAVI AR as defined by echocardiography (P 0.17 corresponded to moderate-severe AR on echocardiography (area under the curve 5 0.84). At follow-up (median, 496 days), patients with LVOT-AR 0.17 showed a significant reduction of LV mass index (LVMi; 121 [95148] vs. 140 [112 169] g/m2 , P 5 0.009) and the prevalence of LV hypertrophy (LVH; 64 vs. 88%, P 5 0.001) compared to baseline. In patients with LVOT-AR > 0.17, LVMi (149 [121178] vs. 166 [144188] g/m2 , P 5 0.14) and the prevalence of LVH (74 vs. 87%, P 5 0.23) did not show a significant change. Compared to patients with LVOT-AR 0.17, those with LVOT-AR > 0.17 had an increased 30-day (16.4% vs. 7.1%, P 5 0.035) and one year mortality (32.9 vs. 14.2%, log rank P value 5 0.001; HR 2.690 [1.4614.953], P 5 0.001). LVOT-AR > 0.17 corresponds to greater than mild AR as defined by echocardiography and predicts impaired LV reverse remodeling and increased early and midterm mortality after TAVI.
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Collection:
National databases
/
Brazil
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Aortic Valve Stenosis
/
Angiography
/
Echocardiography
Type of study:
Prognostic study
/
Risk factors
Language:
English
Journal:
Catheter. cardiovasc. interv
Year:
2017
Document type:
Article
Institution/Affiliation country:
Erasmus Medical Center/NL
/
Academic Medical Center/NL
/
Hospital Beneficência Portuguesa de São Paulo/BR
/
Hospital Israelita Albert Einstein/BR
/
Imperial College London/GB
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Instituto de Cardiologia do Rio Grande do Sul/BR
/
Instituto do Coração/BR