Assessment of paravalvular regurgitation after transcatheter aortic valve replacement by hemodynamic measurements and cardiac magnetic resonance (APPOSE trial)
| العنوان: | Assessment of paravalvular regurgitation after transcatheter aortic valve replacement by hemodynamic measurements and cardiac magnetic resonance (APPOSE trial) |
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| المؤلفون: | M J P Rooijakkers, N A Stens, M H Van Wely, K Van Der Wulp, L Rodwell, H Gehlmann, L A F M Van Garsse, G S C Geuzebroek, M W A Verkroost, J Habets, S El Messaoudi, D H J Thijssen, R Nijveldt, N Van Royen |
| المصدر: | European Heart Journal. 43 |
| بيانات النشر: | Oxford University Press (OUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Cardiology and Cardiovascular Medicine |
| الوصف: | Background Paravalvular regurgitation (PVR) is a common complication after transcatheter aortic valve replacement (TAVR) which poses an increased risk of rehospitalization for heart failure and mortality. Purpose To assess the accuracy of hemodynamic indices to detect relevant PVR as compared to gold-standard cardiac magnetic resonance (CMR) quantitative flow assessment. Methods In this prospective single-centre clinical trial, four hemodynamic indices of PVR measured directly after TAVR were assessed for their correlation with CMR regurgitant fraction (CMR-RF) at one month follow-up: diastolic delta (DD), heart rate adjusted diastolic delta (HR-DD), aortic regurgitation index (ARI) and aortic regurgitation index ratio (ARI ratio). The hemodynamic indices were analyzed for their ability to detect relevant PVR (defined as more than mild PVR, CMR-RF >20%) using receiver operating characteristic (ROC) curves. Results We examined 77 patients in whom CMR was performed one month after TAVR. Mean age was 80.4±5.1 years and 46.8% of patients were men. Mean CMR-RF was 12.4±9.3%. Sixty-two (80.5%) patients had ≤ mild PVR (CMR-RF ≤20%), 14 (18.2%) patients had moderate PVR (CMR-RF 21–39%) and one (1.3%) patient had severe PVR (CMR-RF ≥40%). DD was the best hemodynamic index to discriminate between relevant and non-relevant PVR (area under the curve (AUC) 0.82; 95% CI, 0.72–0.92), followed by HR-DD (AUC 0.78; 95% CI 0.67–0.89), ARI (AUC 0.78, 95% CI 0.66–0.89) and ARI ratio (AUC 0.65; 95% CI 0.49–0.81). Conclusions Diastolic delta measured directly after TAVR has a high accuracy to predict relevant PVR at one month follow-up as assessed by CMR. Correction for heart rate (HR-DD) or systolic blood pressure (ARI, ARI ratio) does not improve this accuracy. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Abbott Medical |
| تدمد: | 1522-9645 0195-668X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::6daf771d0b9f55652e74c109429ea5f3 https://doi.org/10.1093/eurheartj/ehac544.1594 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........6daf771d0b9f55652e74c109429ea5f3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15229645 0195668X |
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