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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Angiographic assessment of aortic regurgitation by video-densitometry in the setting of TAVI: Echocardiographic and clinical correlates
Catheterization and Cardiovascular Interventions, Volume 90, No. 4, Year 2017
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Description
Objectives: We sought to investigate a new angiographic method for aortic regurgitation (AR) severity assessment in the setting of transcatheter aortic valve implantation (TAVI). Background: AR after TAVI is common but challenging to quantitate, especially in the cath-lab. Methods: 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. Results: LVOT-AR was 0.10 ± 0.08, 0.13 ± 0.10 and 0.28 ± 0.14 in none-trace, mild and moderate-severe post-TAVI AR as defined by echocardiography (P < 0.001) and a cutpoint of >0.17 corresponded to moderate-severe AR on echocardiography (area under the curve = 0.84). At follow-up (median, 496 days), patients with LVOT-AR ≤ 0.17 showed a significant reduction of LV mass index (LVMi; 121 [95–148] vs. 140 [112–169] g/m2, P = 0.009) and the prevalence of LV hypertrophy (LVH; 64 vs. 88%, P = 0.001) compared to baseline. In patients with LVOT-AR > 0.17, LVMi (149 [121–178] vs. 166 [144–188] g/m2, P = 0.14) and the prevalence of LVH (74 vs. 87%, P = 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 = 0.035) and one year mortality (32.9 vs. 14.2%, log rank P value = 0.001; HR: 2.690 [1.461–4.953], P = 0.001). Conclusions: 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. © 2017 Wiley Periodicals, Inc.
Authors & Co-Authors
Abdelghani, Mohammad
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Egypt, Cairo
Faculty of Medicine
Tateishi, Hiroki
Netherlands, Rotterdam
Erasmus Mc
Miyazaki, Yosuke
Netherlands, Rotterdam
Erasmus Mc
Cavalcante, Rafael
Netherlands, Rotterdam
Erasmus Mc
Soliman, O. I.I.
Netherlands, Rotterdam
Erasmus Mc
Netherlands, Rotterdam
Cardialysis bv
Tijssen, Jan G.P.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
de Winter, Robbert Jan
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Baan, Jan A.N.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Onuma, Yosinobu
Netherlands, Rotterdam
Erasmus Mc
Netherlands, Rotterdam
Cardialysis bv
Campos, Carlos M.
Brazil, Sao Paulo
Universidade de São Paulo
Brazil, Sao Paulo
Hospital Israelita Albert Einstein
Leite, Rogério S.
Brazil, Porto Alegre
Instituto de Cardiologia/fundacao Universitaria de Cardiologia
Mangione, José Armando
Brazil, Paraiso
Beneficenca Portuguesa Hospital Sao Paulo
Abizaid, Alexandre A.C.
Brazil, Sao Paulo
Universidade de São Paulo
Brazil, Sao Paulo
Instituto Dante Pazzanese de Cardiologia
Lemos, Pedro A.
Brazil, Sao Paulo
Universidade de São Paulo
de Brito, Fábio Sândoli
Brazil, Sao Paulo
Hospital Israelita Albert Einstein
Serruys, Patrick W.
United Kingdom, London
Imperial College London
Statistics
Citations: 24
Authors: 16
Affiliations: 10
Identifiers
Doi:
10.1002/ccd.26926
ISSN:
15221946
e-ISSN:
1522726X
Study Design
Cross Sectional Study
Cohort Study