| Title |
Prognostic value of T1-mapping in TAVR patients: extra-cellular volume as a possible predictor for peri- and post-TAVR adverse events
|
|---|---|
| Published in |
The International Journal of Cardiovascular Imaging, July 2016
|
| DOI | 10.1007/s10554-016-0948-3 |
| Pubmed ID | |
| Authors |
Jonathan Nadjiri, Hanna Nieberler, Eva Hendrich, Albrecht Will, Costanza Pellegrini, Oliver Husser, Christian Hengstenberg, Andreas Greiser, Stefan Martinoff, Martin Hadamitzky |
| Abstract |
The benefit of a transcatheter aortic valve replacement (TAVR) can differ in patients, and therapy bears severe risks. High-degree aortic stenosis can lead to cardiac damage such as diffuse myocardial fibrosis, evaluable by extra-cellular volume (ECV) in CMR. Therefore, fibrosis might be a possible risk factor for unfavorable outcome after TAVR. We sought to assess the prognostic value of T1-mapping and ECV to predict adverse events during and after TAVR. The study population consisted of patients undergoing clinically indicated TAVR by performing additional CMR with native and contrast-enhanced T1-mapping sequences for additional evaluation of ECV. Study endpoints were congestive heart failure (CHF) and TAVR-associated conduction abnormalities defined as new onset of left bundle branch block (LBBB), AV-Block or implantation of a pacemaker. 94 patients were examined and followed. Median follow up time was 187 days (IQR 79-357 days). ECV was increased (>30 %) in 38 patients (40 %). There was no significant correlation between ECV and death, Hazard ratio (HR) 0.847 (95 % CI 0.335; 2.14), p = 0.72. ECV in patients with subsequent CHF was higher than in those without an event (33.5 ± 4.6 and 29.1 ± 4.1 %, respectively), but the difference just did not reach the level of significance HR 2.16 (95 % CI 0.969; 4.84), p = 0.06. Patients with post-TAVR conduction abnormality (LBBB, AV-block or pacemaker implantation) had statistically relevant lower ECV values compared to those without an event. Patients with an event had a mean ECV of 28.1 ± 3.16 %; patients without an event had a mean ECV of 29.8 ± 4.53, HR 0.56 (95 % CI 0.32; 0.96), p = 0.036. In this study, elevated myocardial ECV is a predictor of CHF by trend; CMR may be helpful in identifying patients with a high risk for post-TAVR cardiac decompensation benefitting from an intensified post-interventional surveillance. Patients with post-TAVR conductions abnormalities have a significantly decreased ECV. Nevertheless, it remains unclear which precise molecular tissue alteration is the protective factor or risk factor in this case. |
Mendeley readers
The data shown below were compiled from readership statistics for 45 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 45 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 7 | 16% |
| Student > Master | 5 | 11% |
| Other | 5 | 11% |
| Student > Doctoral Student | 5 | 11% |
| Student > Bachelor | 4 | 9% |
| Other | 11 | 24% |
| Unknown | 8 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 29 | 64% |
| Agricultural and Biological Sciences | 1 | 2% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Computer Science | 1 | 2% |
| Neuroscience | 1 | 2% |
| Other | 0 | 0% |
| Unknown | 12 | 27% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 July 2016.
All research outputs
#20,656,820
of 25,374,647 outputs
Outputs from The International Journal of Cardiovascular Imaging
#1,292
of 2,012 outputs
Outputs of similar age
#298,045
of 380,108 outputs
Outputs of similar age from The International Journal of Cardiovascular Imaging
#20
of 37 outputs
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