Myocardial analysis from routine 4D cardiac-CT to predict reverse remodeling and clinical outcomes after transcatheter aortic valve implantation
[Display omitted] •Reverse remodeling occurs frequently after transcatheter aortic valve implantation (TAVI).•4D cardiac CT based LV mass index and LVEF can predict reverse remodeling after TAVI.•4D cardiac CT can identify patients at high risk of mortality following TAVI. Our study aimed to determi...
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| Veröffentlicht in: | European journal of radiology 2024-06, Vol.175, p.111425-111425, Article 111425 |
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| creator | Bernhard, Benedikt Schütze, Jonathan Leib, Zoe L. Spano, Giancarlo Boscolo Berto, Martina Bakula, Adam Tomii, Daijiro Shiri, Isaac Brugger, Nicolas De Marchi, Stefano Reineke, David Dobner, Stephan Heg, Dik Praz, Fabien Lanz, Jonas Stortecky, Stefan Pilgrim, Thomas Windecker, Stephan Gräni, Christoph |
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•Reverse remodeling occurs frequently after transcatheter aortic valve implantation (TAVI).•4D cardiac CT based LV mass index and LVEF can predict reverse remodeling after TAVI.•4D cardiac CT can identify patients at high risk of mortality following TAVI.
Our study aimed to determine whether 4D cardiac computed tomography (4DCCT) based quantitative myocardial analysis may improve risk stratification and can predict reverse remodeling (RRM) and mortality after transcatheter aortic valve implantation (TAVI).
Consecutive patients undergoing clinically indicated 4DCCT prior to TAVI were prospectively enrolled. 4DCCT-derived left- (LV) and right ventricular (RV), and left atrial (LA) dimensions, mass, ejection fraction (EF) and myocardial strain were evaluated to predict RRM and survival. RRM was defined by either relative increase in LVEF by 5% or relative decline in LV end diastolic diameter (LVEDD) by 5% assessed by transthoracic echocardiography prior TAVI, at discharge, and at 12-month follow-up compared to baseline prior to TAVI.
Among 608 patients included in this study (55 % males, age 81 ± 6.6 years), RRM was observed in 279 (54 %) of 519 patients at discharge and in 218 (48 %) of 453 patients at 12-month echocardiography. While no CCT based measurements predicted RRM at discharge, CCT based LV mass index and LVEF independently predicted RRM at 12-month (ORadj = 1.012; 95 %CI:1.001–1.024; p = 0.046 and ORadj = 0.969; 95 %CI:0.943–0.996; p = 0.024, respectively). The most pronounced changes in LVEF and LVEDD were observed in patients with impaired LV function at baseline. In multivariable analysis age (HRadj = 1.037; 95 %CI:1.005–1.070; p = 0.022) and CCT-based LVEF (HRadj = 0.972; 95 %CI:0.945–0.999; p = 0.048) and LAEF (HRadj = 0.982; 95 %CI:0.968–0.996; p = 0.011) independently predicted survival.
Comprehensive myocardial functional information derived from routine 4DCCT in patients with severe aortic stenosis undergoing TAVI could predict reverse remodeling and clinical outcomes at 12-month following TAVI. |
| doi_str_mv | 10.1016/j.ejrad.2024.111425 |
| format | Article |
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•Reverse remodeling occurs frequently after transcatheter aortic valve implantation (TAVI).•4D cardiac CT based LV mass index and LVEF can predict reverse remodeling after TAVI.•4D cardiac CT can identify patients at high risk of mortality following TAVI.
Our study aimed to determine whether 4D cardiac computed tomography (4DCCT) based quantitative myocardial analysis may improve risk stratification and can predict reverse remodeling (RRM) and mortality after transcatheter aortic valve implantation (TAVI).
Consecutive patients undergoing clinically indicated 4DCCT prior to TAVI were prospectively enrolled. 4DCCT-derived left- (LV) and right ventricular (RV), and left atrial (LA) dimensions, mass, ejection fraction (EF) and myocardial strain were evaluated to predict RRM and survival. RRM was defined by either relative increase in LVEF by 5% or relative decline in LV end diastolic diameter (LVEDD) by 5% assessed by transthoracic echocardiography prior TAVI, at discharge, and at 12-month follow-up compared to baseline prior to TAVI.
Among 608 patients included in this study (55 % males, age 81 ± 6.6 years), RRM was observed in 279 (54 %) of 519 patients at discharge and in 218 (48 %) of 453 patients at 12-month echocardiography. While no CCT based measurements predicted RRM at discharge, CCT based LV mass index and LVEF independently predicted RRM at 12-month (ORadj = 1.012; 95 %CI:1.001–1.024; p = 0.046 and ORadj = 0.969; 95 %CI:0.943–0.996; p = 0.024, respectively). The most pronounced changes in LVEF and LVEDD were observed in patients with impaired LV function at baseline. In multivariable analysis age (HRadj = 1.037; 95 %CI:1.005–1.070; p = 0.022) and CCT-based LVEF (HRadj = 0.972; 95 %CI:0.945–0.999; p = 0.048) and LAEF (HRadj = 0.982; 95 %CI:0.968–0.996; p = 0.011) independently predicted survival.
Comprehensive myocardial functional information derived from routine 4DCCT in patients with severe aortic stenosis undergoing TAVI could predict reverse remodeling and clinical outcomes at 12-month following TAVI.</description><identifier>ISSN: 0720-048X</identifier><identifier>EISSN: 1872-7727</identifier><identifier>DOI: 10.1016/j.ejrad.2024.111425</identifier><identifier>PMID: 38490128</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>4D cardiac computed tomography ; Aged ; Aged, 80 and over ; Aortic stenosis ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - surgery ; Clinical outcomes ; Ct strain ; Echocardiography - methods ; Female ; Four-Dimensional Computed Tomography - methods ; Humans ; Male ; Prospective Studies ; Reverse remodeling ; Tavi ; Transcatheter Aortic Valve Replacement ; Treatment Outcome ; Ventricular Remodeling</subject><ispartof>European journal of radiology, 2024-06, Vol.175, p.111425-111425, Article 111425</ispartof><rights>2024 The Author(s)</rights><rights>Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-1126d5d6ba154f5a9ce341772e3a66f42793baf6bb043e17c40513336e0832723</citedby><cites>FETCH-LOGICAL-c404t-1126d5d6ba154f5a9ce341772e3a66f42793baf6bb043e17c40513336e0832723</cites><orcidid>0000-0002-0996-9681</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejrad.2024.111425$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38490128$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bernhard, Benedikt</creatorcontrib><creatorcontrib>Schütze, Jonathan</creatorcontrib><creatorcontrib>Leib, Zoe L.</creatorcontrib><creatorcontrib>Spano, Giancarlo</creatorcontrib><creatorcontrib>Boscolo Berto, Martina</creatorcontrib><creatorcontrib>Bakula, Adam</creatorcontrib><creatorcontrib>Tomii, Daijiro</creatorcontrib><creatorcontrib>Shiri, Isaac</creatorcontrib><creatorcontrib>Brugger, Nicolas</creatorcontrib><creatorcontrib>De Marchi, Stefano</creatorcontrib><creatorcontrib>Reineke, David</creatorcontrib><creatorcontrib>Dobner, Stephan</creatorcontrib><creatorcontrib>Heg, Dik</creatorcontrib><creatorcontrib>Praz, Fabien</creatorcontrib><creatorcontrib>Lanz, Jonas</creatorcontrib><creatorcontrib>Stortecky, Stefan</creatorcontrib><creatorcontrib>Pilgrim, Thomas</creatorcontrib><creatorcontrib>Windecker, Stephan</creatorcontrib><creatorcontrib>Gräni, Christoph</creatorcontrib><title>Myocardial analysis from routine 4D cardiac-CT to predict reverse remodeling and clinical outcomes after transcatheter aortic valve implantation</title><title>European journal of radiology</title><addtitle>Eur J Radiol</addtitle><description>[Display omitted]
•Reverse remodeling occurs frequently after transcatheter aortic valve implantation (TAVI).•4D cardiac CT based LV mass index and LVEF can predict reverse remodeling after TAVI.•4D cardiac CT can identify patients at high risk of mortality following TAVI.
Our study aimed to determine whether 4D cardiac computed tomography (4DCCT) based quantitative myocardial analysis may improve risk stratification and can predict reverse remodeling (RRM) and mortality after transcatheter aortic valve implantation (TAVI).
Consecutive patients undergoing clinically indicated 4DCCT prior to TAVI were prospectively enrolled. 4DCCT-derived left- (LV) and right ventricular (RV), and left atrial (LA) dimensions, mass, ejection fraction (EF) and myocardial strain were evaluated to predict RRM and survival. RRM was defined by either relative increase in LVEF by 5% or relative decline in LV end diastolic diameter (LVEDD) by 5% assessed by transthoracic echocardiography prior TAVI, at discharge, and at 12-month follow-up compared to baseline prior to TAVI.
Among 608 patients included in this study (55 % males, age 81 ± 6.6 years), RRM was observed in 279 (54 %) of 519 patients at discharge and in 218 (48 %) of 453 patients at 12-month echocardiography. While no CCT based measurements predicted RRM at discharge, CCT based LV mass index and LVEF independently predicted RRM at 12-month (ORadj = 1.012; 95 %CI:1.001–1.024; p = 0.046 and ORadj = 0.969; 95 %CI:0.943–0.996; p = 0.024, respectively). The most pronounced changes in LVEF and LVEDD were observed in patients with impaired LV function at baseline. In multivariable analysis age (HRadj = 1.037; 95 %CI:1.005–1.070; p = 0.022) and CCT-based LVEF (HRadj = 0.972; 95 %CI:0.945–0.999; p = 0.048) and LAEF (HRadj = 0.982; 95 %CI:0.968–0.996; p = 0.011) independently predicted survival.
Comprehensive myocardial functional information derived from routine 4DCCT in patients with severe aortic stenosis undergoing TAVI could predict reverse remodeling and clinical outcomes at 12-month following TAVI.</description><subject>4D cardiac computed tomography</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic stenosis</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Clinical outcomes</subject><subject>Ct strain</subject><subject>Echocardiography - methods</subject><subject>Female</subject><subject>Four-Dimensional Computed Tomography - methods</subject><subject>Humans</subject><subject>Male</subject><subject>Prospective Studies</subject><subject>Reverse remodeling</subject><subject>Tavi</subject><subject>Transcatheter Aortic Valve Replacement</subject><subject>Treatment Outcome</subject><subject>Ventricular Remodeling</subject><issn>0720-048X</issn><issn>1872-7727</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS1URKeFJ0BCXnaTqf8SJwsW1QBtpSI2RWJn3dg34FESD7ZnpHkLHhlPU7pkdW3pO-f-HELec7bmjDfX2zVuI7i1YEKtOedK1K_IirdaVFoLfUZWTAtWMdX-OCcXKW0ZY7XqxBtyLlvVMS7aFfnz9RgsROdhpDDDeEw-0SGGicawz35Gqj7RBbDV5pHmQHcRnbeZRjxgTFjqFByOfv5ZHBy15eVtsSt6GyZMFIaMkeYIc7KQf-HpByFmb-kBxgNSP-1GmDNkH-a35PUAY8J3z_WSfP_y-XFzVz18u73f3DxUVjGVK85F42rX9MBrNdTQWZSKl71RQtMMSuhO9jA0fc-URK6LquZSygZZK4UW8pJcLb67GH7vMWUz-WRxLINg2CcjuroVXSeULqhcUBtDShEHs4t-gng0nJlTFGZrnqIwpyjMEkVRfXhusO8ndC-af7cvwMcFwLLmwWM0yXqcbbluRJuNC_6_Df4CpcOdOA</recordid><startdate>202406</startdate><enddate>202406</enddate><creator>Bernhard, Benedikt</creator><creator>Schütze, Jonathan</creator><creator>Leib, Zoe L.</creator><creator>Spano, Giancarlo</creator><creator>Boscolo Berto, Martina</creator><creator>Bakula, Adam</creator><creator>Tomii, Daijiro</creator><creator>Shiri, Isaac</creator><creator>Brugger, Nicolas</creator><creator>De Marchi, Stefano</creator><creator>Reineke, David</creator><creator>Dobner, Stephan</creator><creator>Heg, Dik</creator><creator>Praz, Fabien</creator><creator>Lanz, Jonas</creator><creator>Stortecky, Stefan</creator><creator>Pilgrim, Thomas</creator><creator>Windecker, Stephan</creator><creator>Gräni, Christoph</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0996-9681</orcidid></search><sort><creationdate>202406</creationdate><title>Myocardial analysis from routine 4D cardiac-CT to predict reverse remodeling and clinical outcomes after transcatheter aortic valve implantation</title><author>Bernhard, Benedikt ; Schütze, Jonathan ; Leib, Zoe L. ; Spano, Giancarlo ; Boscolo Berto, Martina ; Bakula, Adam ; Tomii, Daijiro ; Shiri, Isaac ; Brugger, Nicolas ; De Marchi, Stefano ; Reineke, David ; Dobner, Stephan ; Heg, Dik ; Praz, Fabien ; Lanz, Jonas ; Stortecky, Stefan ; Pilgrim, Thomas ; Windecker, Stephan ; Gräni, Christoph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-1126d5d6ba154f5a9ce341772e3a66f42793baf6bb043e17c40513336e0832723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>4D cardiac computed tomography</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic stenosis</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Clinical outcomes</topic><topic>Ct strain</topic><topic>Echocardiography - methods</topic><topic>Female</topic><topic>Four-Dimensional Computed Tomography - methods</topic><topic>Humans</topic><topic>Male</topic><topic>Prospective Studies</topic><topic>Reverse remodeling</topic><topic>Tavi</topic><topic>Transcatheter Aortic Valve Replacement</topic><topic>Treatment Outcome</topic><topic>Ventricular Remodeling</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bernhard, Benedikt</creatorcontrib><creatorcontrib>Schütze, Jonathan</creatorcontrib><creatorcontrib>Leib, Zoe L.</creatorcontrib><creatorcontrib>Spano, Giancarlo</creatorcontrib><creatorcontrib>Boscolo Berto, Martina</creatorcontrib><creatorcontrib>Bakula, Adam</creatorcontrib><creatorcontrib>Tomii, Daijiro</creatorcontrib><creatorcontrib>Shiri, Isaac</creatorcontrib><creatorcontrib>Brugger, Nicolas</creatorcontrib><creatorcontrib>De Marchi, Stefano</creatorcontrib><creatorcontrib>Reineke, David</creatorcontrib><creatorcontrib>Dobner, Stephan</creatorcontrib><creatorcontrib>Heg, Dik</creatorcontrib><creatorcontrib>Praz, Fabien</creatorcontrib><creatorcontrib>Lanz, Jonas</creatorcontrib><creatorcontrib>Stortecky, Stefan</creatorcontrib><creatorcontrib>Pilgrim, Thomas</creatorcontrib><creatorcontrib>Windecker, Stephan</creatorcontrib><creatorcontrib>Gräni, Christoph</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bernhard, Benedikt</au><au>Schütze, Jonathan</au><au>Leib, Zoe L.</au><au>Spano, Giancarlo</au><au>Boscolo Berto, Martina</au><au>Bakula, Adam</au><au>Tomii, Daijiro</au><au>Shiri, Isaac</au><au>Brugger, Nicolas</au><au>De Marchi, Stefano</au><au>Reineke, David</au><au>Dobner, Stephan</au><au>Heg, Dik</au><au>Praz, Fabien</au><au>Lanz, Jonas</au><au>Stortecky, Stefan</au><au>Pilgrim, Thomas</au><au>Windecker, Stephan</au><au>Gräni, Christoph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myocardial analysis from routine 4D cardiac-CT to predict reverse remodeling and clinical outcomes after transcatheter aortic valve implantation</atitle><jtitle>European journal of radiology</jtitle><addtitle>Eur J Radiol</addtitle><date>2024-06</date><risdate>2024</risdate><volume>175</volume><spage>111425</spage><epage>111425</epage><pages>111425-111425</pages><artnum>111425</artnum><issn>0720-048X</issn><eissn>1872-7727</eissn><abstract>[Display omitted]
•Reverse remodeling occurs frequently after transcatheter aortic valve implantation (TAVI).•4D cardiac CT based LV mass index and LVEF can predict reverse remodeling after TAVI.•4D cardiac CT can identify patients at high risk of mortality following TAVI.
Our study aimed to determine whether 4D cardiac computed tomography (4DCCT) based quantitative myocardial analysis may improve risk stratification and can predict reverse remodeling (RRM) and mortality after transcatheter aortic valve implantation (TAVI).
Consecutive patients undergoing clinically indicated 4DCCT prior to TAVI were prospectively enrolled. 4DCCT-derived left- (LV) and right ventricular (RV), and left atrial (LA) dimensions, mass, ejection fraction (EF) and myocardial strain were evaluated to predict RRM and survival. RRM was defined by either relative increase in LVEF by 5% or relative decline in LV end diastolic diameter (LVEDD) by 5% assessed by transthoracic echocardiography prior TAVI, at discharge, and at 12-month follow-up compared to baseline prior to TAVI.
Among 608 patients included in this study (55 % males, age 81 ± 6.6 years), RRM was observed in 279 (54 %) of 519 patients at discharge and in 218 (48 %) of 453 patients at 12-month echocardiography. While no CCT based measurements predicted RRM at discharge, CCT based LV mass index and LVEF independently predicted RRM at 12-month (ORadj = 1.012; 95 %CI:1.001–1.024; p = 0.046 and ORadj = 0.969; 95 %CI:0.943–0.996; p = 0.024, respectively). The most pronounced changes in LVEF and LVEDD were observed in patients with impaired LV function at baseline. In multivariable analysis age (HRadj = 1.037; 95 %CI:1.005–1.070; p = 0.022) and CCT-based LVEF (HRadj = 0.972; 95 %CI:0.945–0.999; p = 0.048) and LAEF (HRadj = 0.982; 95 %CI:0.968–0.996; p = 0.011) independently predicted survival.
Comprehensive myocardial functional information derived from routine 4DCCT in patients with severe aortic stenosis undergoing TAVI could predict reverse remodeling and clinical outcomes at 12-month following TAVI.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>38490128</pmid><doi>10.1016/j.ejrad.2024.111425</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-0996-9681</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | 4D cardiac computed tomography Aged Aged, 80 and over Aortic stenosis Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - surgery Clinical outcomes Ct strain Echocardiography - methods Female Four-Dimensional Computed Tomography - methods Humans Male Prospective Studies Reverse remodeling Tavi Transcatheter Aortic Valve Replacement Treatment Outcome Ventricular Remodeling |
| title | Myocardial analysis from routine 4D cardiac-CT to predict reverse remodeling and clinical outcomes after transcatheter aortic valve implantation |
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