Valvular & structural heart disease
Regional Distribution of Extracellular Volume Quantified by Cardiac CT in Aortic Stenosis: Insights Into Disease Mechanisms and Impact on Outcomes
Authors' conclusion
Regional differences in ECVCT suggest a predilection for fibrosis and amyloid infiltration at the base, subendocardium, inferior wall, and septum more than the anterior and lateral myocardium. ECVCT can predict long-term mortality with the subepicardium demonstrating the strongest discriminatory power.
Study context
- Population
- Patients with aortic stenosis (AS) (with or without transthyretin cardiac amyloidosis) referred for TAVR, and controls
- Participants
- 199 patients
- Exposure
- Global and regional ECV by cardiac CT in AS, AS with transthyretin cardiac amyloidosis and controls
- Controlsn = 65reference
- ASn = 115
- AS and transthyretin cardiac amyloidosisn = 19
- Outcome
- Global ECV by CT
Methodological details3 prospective cohorts
- 3 prospective cohorts
Main finding
As reported in the abstract
P < 0.001
- Across cohorts, ECV by CT higher at base vs apex, inferoseptum vs anterolateral wall, and subendocardium vs subepicardium
- P < 0.05 for all
Observational data: associations, not effects.
Further findings
Mortality by epicardial ECVCT (AS patients) · median 3.9 (max 6.3) years
| Adjusted HR (95% CI) | P value | ||
|---|---|---|---|
| Epicardial ECVCT | 1.21 (1.08–1.36) | P = 0.002 | |
| 0.512Adjusted hazard ratio (log scale) |
- Mortality by epicardial ECVCT (AS patients): strongest predictor vs any other regional value or global ECVCT
Original publication
Regional Distribution of Extracellular Volume Quantified by Cardiac CT in Aortic Stenosis: Insights Into Disease Mechanisms and Impact on Outcomes. Circ Cardiovasc Imaging. Published 21 May 2024. doi:10.
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