Angiographic assessment of aortic regurgitation by video-densitometry in the setting of TAVI: echocardiographic and clinical correlates
Catheter. cardiovasc. interv
; 90(4): 650-659, 2017. ilus, tab, graf
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1061886
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
We sought to investigate a new angiographic method for aortic regurgitation (AR) severity assessment in the setting of transcatheter aortic valve implantation (TAVI). AR after TAVI is common but challenging to quantitate, especially in the cath-lab. In 228 patients, AR was quantitated before and after TAVI by echocardiography and by video-densitometric analysis of aortograms. Contrast time density curves for the aortic root (the reference region) and the left ventricular outflow tract, LVOT were generated. LVOT-AR was calculated as the area under the curve of the LVOT as a fraction of the area under the curve of the reference region. LVOT-AR was 0.10 6 0.08, 0.13 6 0.10 and 0.28 6 0.14 in none-trace, mild and moderate-severe post-TAVI AR as defined by echocardiography (P 0.17 corresponded to moderate-severe AR on echocardiography (area under the curve 5 0.84). At follow-up (median, 496 days), patients with LVOT-AR 0.17 showed a significant reduction of LV mass index (LVMi; 121 [95148] vs. 140 [112 169] g/m2 , P 5 0.009) and the prevalence of LV hypertrophy (LVH; 64 vs. 88%, P 5 0.001) compared to baseline. In patients with LVOT-AR > 0.17, LVMi (149 [121178] vs. 166 [144188] g/m2 , P 5 0.14) and the prevalence of LVH (74 vs. 87%, P 5 0.23) did not show a significant change. Compared to patients with LVOT-AR 0.17, those with LVOT-AR > 0.17 had an increased 30-day (16.4% vs. 7.1%, P 5 0.035) and one year mortality (32.9 vs. 14.2%, log rank P value 5 0.001; HR 2.690 [1.4614.953], P 5 0.001). LVOT-AR > 0.17 corresponds to greater than mild AR as defined by echocardiography and predicts impaired LV reverse remodeling and increased early and midterm mortality after TAVI.
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Coleções:
Bases de dados nacionais
/
Brasil
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Doença Cardiovascular
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Estenose da Valva Aórtica
/
Angiografia
/
Ecocardiografia
Tipo de estudo:
Estudo prognóstico
/
Fatores de risco
Idioma:
Inglês
Revista:
Catheter. cardiovasc. interv
Ano de publicação:
2017
Tipo de documento:
Artigo
Instituição/País de afiliação:
Erasmus Medical Center/NL
/
Academic Medical Center/NL
/
Hospital Beneficência Portuguesa de São Paulo/BR
/
Hospital Israelita Albert Einstein/BR
/
Imperial College London/GB
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Instituto de Cardiologia do Rio Grande do Sul/BR
/
Instituto do Coração/BR