Valvular & structural heart disease
Diastolic delta best predicts paravalvular regurgitation after transcatheter aortic valve replacement as assessed by cardiac magnetic resonance: the APPOSE trial
Authors' conclusion
DD measured during TAVR best predicts relevant PVR. Correction for heart rate (HR-DD) or systolic blood pressure (ARI, ARI ratio) did not improve this predictive value.
Study context
- Population
- Patients undergoing transcatheter aortic valve replacement (TAVR)
- Participants
- 77 patients
- Comparison
- Haemodynamic indices of paravalvular regurgitation (PVR) measured during TAVR vs cardiac magnetic resonance (CMR)-derived regurgitant fraction
- Outcome
- Prediction of relevant PVR (CMR-RF > 20%) by AUC
- Follow-up
- 1 month
Methodological detailsprospective, single-centre
- Prospective
- Single-centre
Performance
As reported in the abstract
Relevant PVR (CMR-RF > 20%)
| Test or model | AUC | Optimal cut-off | Sensitivity | Specificity |
|---|---|---|---|---|
| Diastolic delta (DD) | 0.82 (95% CI, 0.72-0.92) | 32 mmHg | 69% | 77% |
| HR-DD | 0.78 (95% CI, 0.67-0.89) | |||
| Aortic regurgitation index (ARI) | 0.78 (95% CI, 0.66-0.89) | |||
| ARI ratio | 0.65 (95% CI, 0.49-0.81) |
AUC
Diastolic delta (DD)0.82 (95% CI, 0.72-0.92)
HR-DD0.78 (95% CI, 0.67-0.89)
Aortic regurgitation index (ARI)0.78 (95% CI, 0.66-0.89)
ARI ratio0.65 (95% CI, 0.49-0.81)
Optimal cut-off
Diastolic delta (DD)32 mmHg
HR-DD— not stated in the abstract
Aortic regurgitation index (ARI)— not stated in the abstract
ARI ratio— not stated in the abstract
Sensitivity
Diastolic delta (DD)69%
HR-DD— not stated in the abstract
Aortic regurgitation index (ARI)— not stated in the abstract
ARI ratio— not stated in the abstract
Specificity
Diastolic delta (DD)77%
HR-DD— not stated in the abstract
Aortic regurgitation index (ARI)— not stated in the abstract
ARI ratio— not stated in the abstract
Further findings
CMR-RF · 41 ± 14 days after TAVR
- Mean CMR-RF
- 12.4 ± 9.3%
- Patients with CMR-RF > 20%
- 15 (19.5%)
Original publication
Diastolic delta best predicts paravalvular regurgitation after transcatheter aortic valve replacement as assessed by cardiac magnetic resonance: the APPOSE trial. Eur Heart J Cardiovasc Imaging. Published 14 March 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →