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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Inter-technique consistency and prognostic value of intra-procedural angiographic and echocardiographic assessment of aortic regurgitation after transcatheter aortic valve implantation
Circulation Journal, Volume 82, No. 9, Year 2018
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Description
Background: We investigated the relationship between intraprocedural angiographic and echocardiographic AR severity after TAVI, and the clinical robustness of angiographic assessment. Methods and Results: In 74 consecutive patients, the echocardiographic circumferential extent (CE) of the paravalvular regurgitant jet was retrospectively measured and graded based on the VARC-2 cut-points; and angiographic post-TAVI AR was retrospectively quantified using contrast videodensitometry (VD) software that calculates the ratio of the contrast time-density integral in the LV outflow tract to that in the ascending aorta (LVOT-AR). Seventy-four echocardiograms immediately after TAVI were analyzable, while 51 aortograms were analyzable for VD. These 51 echocardiograms and VD were evaluated. Median LVOT-AR across the echocardiographic AR grades was as follows: none-trace, 0.07 (IQR, 0.05–0.11); mild, 0.12 (IQR, 0.09–0.15); and moderate, 0.17 (IQR, 0.15–0.22; P<0.05 for none-trace vs. mild, and mild vs. moderate). LVOT-AR strongly correlated with %CE (r=0.72, P<0.0001). At 1 year, the rate of the composite end-point of all-cause death or HF re-hospitalization was significantly higher in >mild AR patients compared with no-mild AR on intra-procedural echocardiography (41.5% vs. 12.4%, P=0.03) as well as in patients with LVOT-AR >0.17 compared with LVOT-AR ≤0.17 (59.5% vs. 16.6%, P=0.03). Conclusions: VD (LVOT-AR) has good intra-procedural inter-technique consistency and clinical robustness. Greater than mild post-TAVI AR, but not mild post-TAVI AR, is associated with late mortality. © 2018, Japanese Circulation Society. All rights reserved.
Authors & Co-Authors
Tateishi, Hiroki
Japan, Ube
Yamaguchi University Graduate School of Medicine
Miyazaki, Yosuke
Netherlands, Rotterdam
Erasmus Mc
Abdelghani, Mohammad
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Modolo, Rodrigo G.P.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Fujimura, Tatsuhiro
Japan, Ube
Yamaguchi University Graduate School of Medicine
Soliman, O. I.I.
Netherlands, Rotterdam
Erasmus Mc
Onuma, Yosinobu
Netherlands, Rotterdam
Erasmus Mc
Serruys, Patrick W.
United Kingdom, London
Imperial College London
Statistics
Citations: 11
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1253/circj.CJ-17-1376
ISSN:
13469843