Valvular & structural heart disease
Prognostic value of myocardial computed tomography–derived extracellular volume in severe aortic stenosis requiring aortic valve replacement: a systematic review and meta-analysis
Pooled result · Composite of cardiovascular outcomesResult — go to the resultOdds ratio 4.3 95% CI 3.192–5.764Authors' conclusion
Patients undergoing AVR for severe AS with elevated CT-ECV values experience a worse post-intervention prognosis. The implementation of CT-ECV evaluation in routine AVR planning protocols should be considered.
Study context
- Population
- Patients with severe aortic stenosis undergoing aortic valve replacementpatients undergoing aortic valve replacement (AVR) for severe aortic stenosis (AS) in 10 studies
- Participants
- 1,223 patients
- Comparison
- Patients with severe AS undergoing AVR with elevated myocardial CT-ECV values vs. patients with normal values
- Elevated CT-ECVn = 524
- Normal CT-ECVn = 699reference
- Outcome
- Composite of cardiovascular outcomes
- Follow-up
- Mean 17.9 ± 2.3 months after AVR
Pooled result
As reported in the abstract
Odds ratio
4.3
95% CI 3.192–5.764
P < 0.001
By group
Elevated CT-ECV
43.4
%
Normal CT-ECV
14.0%
Elevated CT-ECVvs normal CT-ECV
OR 4.3 (95% CI 3.192–5.764); P < 0.001
Further pooled results
| Outcome | Elevated CT-ECV | Normal CT-ECV | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| All-cause mortality (secondary) | 29.3% | 11.6% | 3.5 (2.276–5.311) | P < 0.001 | |
| HF hospitalization (secondary) | 25.5% | 5.9% | 4.9 (2.283–10.376) | P < 0.001 | |
| 0.050.21520Odds ratio (log scale) |
Pooled CT-ECV cut-off to define elevated values and predict prognosis
- Pooled CT-ECV cut-off
- 30.7% [95% confidence interval (CI): 28.5-33.7%]
Original publication
Prognostic value of myocardial computed tomography–derived extracellular volume in severe aortic stenosis requiring aortic valve replacement: a systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging. Published 10 January 2025. doi:10.
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