Selecting the optimal candidates for percutaneous mitral valvuloplasty using multi-modality imaging
This study compared echocardiography (echo) and cardiac computed tomography (CT) in measuring the Wilkins score and evaluated the potential added benefit of CT in predicting immediate percutaneous mitral valvuloplasty (PMV) outcomes in rheumatic mitral stenosis (MS) patients deemed eligible for PMV...
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| creator | Lee, Hee Jeong Kim, Na Young Kim, Dae-Young Son, Jang-Won Choi, Kang-Un Lee, Seon-Hwa Kim, In-Cheol Ko, Kyu-Yong Ha, Kyung Eun Gwak, Seo-Yeon Kim, Kyu Seo, Jiwon Kim, Hojeong Shim, Chi Young Ha, Jong-Won Kim, Hyungseop Hong, Geu-Ru Cho, Iksung Suh, Young Joo |
| description | This study compared echocardiography (echo) and cardiac computed tomography (CT) in measuring the Wilkins score and evaluated the potential added benefit of CT in predicting immediate percutaneous mitral valvuloplasty (PMV) outcomes in rheumatic mitral stenosis (MS) patients deemed eligible for PMV by echo.
From a multicentre registry of 3,140 patients with at least moderate MS, we included 96 patients (age 56.4±11.5 years, 81% female) eligible for PMV based on echo Wilkins score (≤9) who underwent PMV and had measurable CT and echo images. We compared Wilkins scores from both modalities and analyzed their relationship with unsuccessful procedural outcomes, defined as suboptimal post-procedural mitral valve area ( |
| doi_str_mv | 10.1093/ehjci/jeae334 |
| format | Article |
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From a multicentre registry of 3,140 patients with at least moderate MS, we included 96 patients (age 56.4±11.5 years, 81% female) eligible for PMV based on echo Wilkins score (≤9) who underwent PMV and had measurable CT and echo images. We compared Wilkins scores from both modalities and analyzed their relationship with unsuccessful procedural outcomes, defined as suboptimal post-procedural mitral valve area (<1.5 cm2) or newly developed mitral regurgitation grade ≥III. The mean CT score was higher than the echo score (8.0±2.4 vs. 7.3±1.2 point, p =0.005). Procedural success was achieved in 65 (67.7 %) patients. Unsuccessful results occurred in 31 patients, primarily in intermediate echo score (7-9 points) group. Among patients with intermediate echo scores, 90% had high CT scores (≥9), which were associated with significantly higher rates of unsuccessful PMV compared to lower CT scores (61.1% vs 18.9%, p<0.001).
CT-derived Wilkins scores were higher than echo-derived scores, with the most significant discrepancy in the intermediate echo score group. CT identified a subgroup of patients at higher risk for unsuccessful PMV among those with intermediate echo-based feasibility. Patients with intermediate echo-based PMV feasibility may benefit from CT-based reclassification, potentially improving patient selection and procedural outcomes.</description><identifier>ISSN: 2047-2404</identifier><identifier>ISSN: 2047-2412</identifier><identifier>EISSN: 2047-2412</identifier><identifier>DOI: 10.1093/ehjci/jeae334</identifier><identifier>PMID: 39737766</identifier><language>eng</language><publisher>England</publisher><ispartof>European heart journal cardiovascular imaging, 2024-12</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c179t-ee90a6a590cfd97a95010c8d214dfc048a3f6475f3b0e9e29d8bded84d7701e73</cites><orcidid>0000-0002-7334-6083 ; 0000-0001-7056-4221 ; 0000-0002-0243-6954 ; 0000-0002-2078-5832 ; 0000-0002-8109-5018 ; 0000-0002-1620-795X ; 0000-0002-3632-0183 ; 0000-0002-7641-3739 ; 0000-0002-8260-2958 ; 0000-0003-4981-3304 ; 0000-0002-5751-2328 ; 0000-0002-2209-0583 ; 0000-0002-6136-0136 ; 0000-0001-5927-5410 ; 0000-0002-3385-3152 ; 0000-0002-4516-7651 ; 0000-0003-1036-8960 ; 0000-0002-5550-4156</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39737766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Hee Jeong</creatorcontrib><creatorcontrib>Kim, Na Young</creatorcontrib><creatorcontrib>Kim, Dae-Young</creatorcontrib><creatorcontrib>Son, Jang-Won</creatorcontrib><creatorcontrib>Choi, Kang-Un</creatorcontrib><creatorcontrib>Lee, Seon-Hwa</creatorcontrib><creatorcontrib>Kim, In-Cheol</creatorcontrib><creatorcontrib>Ko, Kyu-Yong</creatorcontrib><creatorcontrib>Ha, Kyung Eun</creatorcontrib><creatorcontrib>Gwak, Seo-Yeon</creatorcontrib><creatorcontrib>Kim, Kyu</creatorcontrib><creatorcontrib>Seo, Jiwon</creatorcontrib><creatorcontrib>Kim, Hojeong</creatorcontrib><creatorcontrib>Shim, Chi Young</creatorcontrib><creatorcontrib>Ha, Jong-Won</creatorcontrib><creatorcontrib>Kim, Hyungseop</creatorcontrib><creatorcontrib>Hong, Geu-Ru</creatorcontrib><creatorcontrib>Cho, Iksung</creatorcontrib><creatorcontrib>Suh, Young Joo</creatorcontrib><title>Selecting the optimal candidates for percutaneous mitral valvuloplasty using multi-modality imaging</title><title>European heart journal cardiovascular imaging</title><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><description>This study compared echocardiography (echo) and cardiac computed tomography (CT) in measuring the Wilkins score and evaluated the potential added benefit of CT in predicting immediate percutaneous mitral valvuloplasty (PMV) outcomes in rheumatic mitral stenosis (MS) patients deemed eligible for PMV by echo.
From a multicentre registry of 3,140 patients with at least moderate MS, we included 96 patients (age 56.4±11.5 years, 81% female) eligible for PMV based on echo Wilkins score (≤9) who underwent PMV and had measurable CT and echo images. We compared Wilkins scores from both modalities and analyzed their relationship with unsuccessful procedural outcomes, defined as suboptimal post-procedural mitral valve area (<1.5 cm2) or newly developed mitral regurgitation grade ≥III. The mean CT score was higher than the echo score (8.0±2.4 vs. 7.3±1.2 point, p =0.005). Procedural success was achieved in 65 (67.7 %) patients. Unsuccessful results occurred in 31 patients, primarily in intermediate echo score (7-9 points) group. Among patients with intermediate echo scores, 90% had high CT scores (≥9), which were associated with significantly higher rates of unsuccessful PMV compared to lower CT scores (61.1% vs 18.9%, p<0.001).
CT-derived Wilkins scores were higher than echo-derived scores, with the most significant discrepancy in the intermediate echo score group. CT identified a subgroup of patients at higher risk for unsuccessful PMV among those with intermediate echo-based feasibility. Patients with intermediate echo-based PMV feasibility may benefit from CT-based reclassification, potentially improving patient selection and procedural outcomes.</description><issn>2047-2404</issn><issn>2047-2412</issn><issn>2047-2412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNo9kE1LAzEQhoMottQevcoevaydbLKb5ijFLyh4UM9Lmsy2KdnummQL_femtjqXGV4eXoaHkFsKDxQkm-Fmq-1siwoZ4xdkXAAXecFpcfl_Ax-RaQhbSFPyihf0moyYFEyIqhoT_YEOdbS7dRY3mHV9tK1ymVY7Y42KGLKm81mPXg9R7bAbQtba6BOyV24_uK53KsRDNoRjRTu4aPO2M8rZFKaqdYpvyFWjXMDpeU_I1_PT5-I1X76_vC0el7mmQsYcUYKqVClBN0YKJUugoOemoNw0GvhcsabiomzYClBiIc18ZdDMuRECKAo2Ifen3t533wOGWLc2aHTu9HjNaAksKYAiofkJ1b4LwWNT9z596w81hfqotv5VW5_VJv7uXD2sWjT_9J9I9gNwfXj5</recordid><startdate>20241231</startdate><enddate>20241231</enddate><creator>Lee, Hee Jeong</creator><creator>Kim, Na Young</creator><creator>Kim, Dae-Young</creator><creator>Son, Jang-Won</creator><creator>Choi, Kang-Un</creator><creator>Lee, Seon-Hwa</creator><creator>Kim, In-Cheol</creator><creator>Ko, Kyu-Yong</creator><creator>Ha, Kyung Eun</creator><creator>Gwak, Seo-Yeon</creator><creator>Kim, Kyu</creator><creator>Seo, Jiwon</creator><creator>Kim, Hojeong</creator><creator>Shim, Chi Young</creator><creator>Ha, Jong-Won</creator><creator>Kim, Hyungseop</creator><creator>Hong, Geu-Ru</creator><creator>Cho, Iksung</creator><creator>Suh, Young Joo</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7334-6083</orcidid><orcidid>https://orcid.org/0000-0001-7056-4221</orcidid><orcidid>https://orcid.org/0000-0002-0243-6954</orcidid><orcidid>https://orcid.org/0000-0002-2078-5832</orcidid><orcidid>https://orcid.org/0000-0002-8109-5018</orcidid><orcidid>https://orcid.org/0000-0002-1620-795X</orcidid><orcidid>https://orcid.org/0000-0002-3632-0183</orcidid><orcidid>https://orcid.org/0000-0002-7641-3739</orcidid><orcidid>https://orcid.org/0000-0002-8260-2958</orcidid><orcidid>https://orcid.org/0000-0003-4981-3304</orcidid><orcidid>https://orcid.org/0000-0002-5751-2328</orcidid><orcidid>https://orcid.org/0000-0002-2209-0583</orcidid><orcidid>https://orcid.org/0000-0002-6136-0136</orcidid><orcidid>https://orcid.org/0000-0001-5927-5410</orcidid><orcidid>https://orcid.org/0000-0002-3385-3152</orcidid><orcidid>https://orcid.org/0000-0002-4516-7651</orcidid><orcidid>https://orcid.org/0000-0003-1036-8960</orcidid><orcidid>https://orcid.org/0000-0002-5550-4156</orcidid></search><sort><creationdate>20241231</creationdate><title>Selecting the optimal candidates for percutaneous mitral valvuloplasty using multi-modality imaging</title><author>Lee, Hee Jeong ; Kim, Na Young ; Kim, Dae-Young ; Son, Jang-Won ; Choi, Kang-Un ; Lee, Seon-Hwa ; Kim, In-Cheol ; Ko, Kyu-Yong ; Ha, Kyung Eun ; Gwak, Seo-Yeon ; Kim, Kyu ; Seo, Jiwon ; Kim, Hojeong ; Shim, Chi Young ; Ha, Jong-Won ; Kim, Hyungseop ; Hong, Geu-Ru ; Cho, Iksung ; Suh, Young Joo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c179t-ee90a6a590cfd97a95010c8d214dfc048a3f6475f3b0e9e29d8bded84d7701e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Hee Jeong</creatorcontrib><creatorcontrib>Kim, Na Young</creatorcontrib><creatorcontrib>Kim, Dae-Young</creatorcontrib><creatorcontrib>Son, Jang-Won</creatorcontrib><creatorcontrib>Choi, Kang-Un</creatorcontrib><creatorcontrib>Lee, Seon-Hwa</creatorcontrib><creatorcontrib>Kim, In-Cheol</creatorcontrib><creatorcontrib>Ko, Kyu-Yong</creatorcontrib><creatorcontrib>Ha, Kyung Eun</creatorcontrib><creatorcontrib>Gwak, Seo-Yeon</creatorcontrib><creatorcontrib>Kim, Kyu</creatorcontrib><creatorcontrib>Seo, Jiwon</creatorcontrib><creatorcontrib>Kim, Hojeong</creatorcontrib><creatorcontrib>Shim, Chi Young</creatorcontrib><creatorcontrib>Ha, Jong-Won</creatorcontrib><creatorcontrib>Kim, Hyungseop</creatorcontrib><creatorcontrib>Hong, Geu-Ru</creatorcontrib><creatorcontrib>Cho, Iksung</creatorcontrib><creatorcontrib>Suh, Young Joo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Hee Jeong</au><au>Kim, Na Young</au><au>Kim, Dae-Young</au><au>Son, Jang-Won</au><au>Choi, Kang-Un</au><au>Lee, Seon-Hwa</au><au>Kim, In-Cheol</au><au>Ko, Kyu-Yong</au><au>Ha, Kyung Eun</au><au>Gwak, Seo-Yeon</au><au>Kim, Kyu</au><au>Seo, Jiwon</au><au>Kim, Hojeong</au><au>Shim, Chi Young</au><au>Ha, Jong-Won</au><au>Kim, Hyungseop</au><au>Hong, Geu-Ru</au><au>Cho, Iksung</au><au>Suh, Young Joo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Selecting the optimal candidates for percutaneous mitral valvuloplasty using multi-modality imaging</atitle><jtitle>European heart journal cardiovascular imaging</jtitle><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><date>2024-12-31</date><risdate>2024</risdate><issn>2047-2404</issn><issn>2047-2412</issn><eissn>2047-2412</eissn><abstract>This study compared echocardiography (echo) and cardiac computed tomography (CT) in measuring the Wilkins score and evaluated the potential added benefit of CT in predicting immediate percutaneous mitral valvuloplasty (PMV) outcomes in rheumatic mitral stenosis (MS) patients deemed eligible for PMV by echo.
From a multicentre registry of 3,140 patients with at least moderate MS, we included 96 patients (age 56.4±11.5 years, 81% female) eligible for PMV based on echo Wilkins score (≤9) who underwent PMV and had measurable CT and echo images. We compared Wilkins scores from both modalities and analyzed their relationship with unsuccessful procedural outcomes, defined as suboptimal post-procedural mitral valve area (<1.5 cm2) or newly developed mitral regurgitation grade ≥III. The mean CT score was higher than the echo score (8.0±2.4 vs. 7.3±1.2 point, p =0.005). Procedural success was achieved in 65 (67.7 %) patients. Unsuccessful results occurred in 31 patients, primarily in intermediate echo score (7-9 points) group. Among patients with intermediate echo scores, 90% had high CT scores (≥9), which were associated with significantly higher rates of unsuccessful PMV compared to lower CT scores (61.1% vs 18.9%, p<0.001).
CT-derived Wilkins scores were higher than echo-derived scores, with the most significant discrepancy in the intermediate echo score group. CT identified a subgroup of patients at higher risk for unsuccessful PMV among those with intermediate echo-based feasibility. Patients with intermediate echo-based PMV feasibility may benefit from CT-based reclassification, potentially improving patient selection and procedural outcomes.</abstract><cop>England</cop><pmid>39737766</pmid><doi>10.1093/ehjci/jeae334</doi><orcidid>https://orcid.org/0000-0002-7334-6083</orcidid><orcidid>https://orcid.org/0000-0001-7056-4221</orcidid><orcidid>https://orcid.org/0000-0002-0243-6954</orcidid><orcidid>https://orcid.org/0000-0002-2078-5832</orcidid><orcidid>https://orcid.org/0000-0002-8109-5018</orcidid><orcidid>https://orcid.org/0000-0002-1620-795X</orcidid><orcidid>https://orcid.org/0000-0002-3632-0183</orcidid><orcidid>https://orcid.org/0000-0002-7641-3739</orcidid><orcidid>https://orcid.org/0000-0002-8260-2958</orcidid><orcidid>https://orcid.org/0000-0003-4981-3304</orcidid><orcidid>https://orcid.org/0000-0002-5751-2328</orcidid><orcidid>https://orcid.org/0000-0002-2209-0583</orcidid><orcidid>https://orcid.org/0000-0002-6136-0136</orcidid><orcidid>https://orcid.org/0000-0001-5927-5410</orcidid><orcidid>https://orcid.org/0000-0002-3385-3152</orcidid><orcidid>https://orcid.org/0000-0002-4516-7651</orcidid><orcidid>https://orcid.org/0000-0003-1036-8960</orcidid><orcidid>https://orcid.org/0000-0002-5550-4156</orcidid></addata></record> |
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| title | Selecting the optimal candidates for percutaneous mitral valvuloplasty using multi-modality imaging |
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