Valvular & structural heart disease
Extracellular volume fraction (ECV) derived from pre-operative computed tomography predicts prognosis in patients undergoing transcatheter aortic valve implantation (TAVI)
Main finding · Death or HFHResult — go to the resultHazard ratio 5.92 95% CI 2.37–14.75Authors' conclusion
In this prospective observational cohort study, ECV measured at TAVI planning CT predicts the composite endpoint (HFH or death) in high-risk severe AS patients.
Study context
- Population
- Patients with severe aortic stenosis (AS) undergoing TAVI planning computed tomography (CT), October 2020 to July 2021113 in final population
- Participants
- 159 patients
- Exposure
- Patients with vs without death or heart failure hospitalization (HFH) after TAVI
- Composite endpointn = 23
- Outcome
- Composite of:
- HF hospitalization (HFH)
- Death
- Follow-up
- Median 13 (11-15) months
Methodological detailsconsecutive patients, ECV calculated from myocardium and blood pool attenuations before and 5 min after contrast, adjusted for haematocrit
- Consecutive patients
- ECV calculated from myocardium and blood pool attenuations before and 5 min after contrast, adjusted for haematocrit
Main finding
Death or HFH
Hazard ratio
5.92
95% CI 2.37–14.75
P < 0.001
ECV >31.3%
HR 5.92 (95% CI 2.37–14.75); P < 0.001
As reported in the abstract
- Composite endpoint occurred
- 23/113 (20%)
Observational data: associations, not effects.
Further findings
Baseline characteristics of patients with vs without the composite endpoint
- Lower aortic valve mean pressure gradient in patients with the composite endpoint: 39 (29-48) vs. 46 (40-54) mmHg
- P = 0.002
- Lower LVEF in patients with the composite endpoint: 51 (37-69) vs. 66 (54-74)%
- P = 0.014
- Lower RV EF in patients with the composite endpoint: 45 (31-53) vs. 49 (44-55)%
- P = 0.010
- Higher ECV in patients with the composite endpoint: 31.5 (26.9-34.3) vs. 27.8 (25.3-30.2)%
- P = 0.006
Original publication
Extracellular volume fraction (ECV) derived from pre-operative computed tomography predicts prognosis in patients undergoing transcatheter aortic valve implantation (TAVI). Eur Heart J Cardiovasc Imaging. Published 14 March 2023. doi:10.
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