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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A Novel Angiographic Quantification of Aortic Regurgitation After TAVR Provides an Accurate Estimation of Regurgitation Fraction Derived From Cardiac Magnetic Resonance Imaging
JACC: Cardiovascular Interventions, Volume 11, No. 3, Year 2018
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Description
Objectives: This study sought to compare a new quantitative angiographic technique to cardiac magnetic resonance-derived regurgitation fraction (CMR-RF) for the quantification of prosthetic valve regurgitation (PVR) after transcatheter aortic valve replacement (TAVR). Background: PVR after TAVR is challenging to quantify, especially during the procedure. Methods: Post-replacement aortograms in 135 TAVR recipients were analyzed offline by videodensitometry to measure the ratio of the time-resolved contrast density in the left ventricular outflow tract to that in the aortic root (videodensitometric aortic regurgitation [VD-AR]). CMR was performed within an interval of ≤30 days (11 ± 6 days) after the procedure. Results: The average CMR-RF was 6.7 ± 7.0% whereas the average VD-AR was 7.0 ± 7.0%. The correlation between VD-AR and CMR-RF was substantial (r = 0.78, p < 0.001). On receiver-operating characteristic curves, a VD-AR ≥10% corresponded to >mild PVR as defined by CMR-RF (area under the curve: 0.94; p < 0.001; sensitivity 100%, specificity 83%), whereas a VD-AR ≥25% corresponded to moderate-to-severe PVR (area under the curve: 0.99; p = 0.004; sensitivity 100%, specificity 98%). Intraobserver reproducibility was excellent for both techniques (for CMR-RF, intraclass correlation coefficient: 0.91, p < 0.001; for VD-AR intraclass correlation coefficient: 0.93, p < 0.001). The difference on rerating was –0.04 ± 7.9% for CMR-RF and –0.40 ± 6.8% for VD-AR. Conclusions: The angiographic VD-AR provides a surrogate assessment of PVR severity after TAVR that correlates well with the CMR-RF. © 2018 American College of Cardiology Foundation
Authors & Co-Authors
Abdel-Wahab, Mohamed Kader
Germany, Bad Segeberg
Segeberger Kliniken Gmbh
Abdelghani, Mohammad
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Miyazaki, Yosuke
Netherlands, Rotterdam
Erasmus Mc
Merten, Constanze
Germany, Bad Segeberg
Segeberger Kliniken Gmbh
Zachow, Dirk
Germany, Bad Segeberg
Segeberger Kliniken Gmbh
Onuma, Yosinobu
Netherlands, Rotterdam
Erasmus Mc
Netherlands, Rotterdam
Cardialysis bv
Serruys, Patrick W.
United Kingdom, London
Imperial College London
Richardt, Gert
Germany, Bad Segeberg
Segeberger Kliniken Gmbh
Soliman, O. I.I.
Netherlands, Rotterdam
Erasmus Mc
Netherlands, Rotterdam
Cardialysis bv
Statistics
Citations: 32
Authors: 9
Affiliations: 7
Identifiers
Doi:
10.1016/j.jcin.2017.08.045
ISSN:
19368798
Research Areas
Noncommunicable Diseases
Study Approach
Quantitative