Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis

Background Myocardial extracellular volume fraction (ECV), measured by cardiac magnetic resonance imaging, is a useful prognostic marker for patients who have undergone aortic valve replacement (AVR) for aortic stenosis. However, the prognostic significance of ECV measurements based on computed tomo...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Masataka Suzuki, Takayoshi Toba, Yu Izawa, Hiroshi Fujita, Keisuke Miwa, Yu Takahashi, Hiroyuki Toh, Hiroyuki Kawamori, Hiromasa Otake, Hidekazu Tanaka, Sei Fujiwara, Yoshiaki Watanabe, Atsushi K. Kono, Kenji Okada, Ken‐ichi Hirata
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	aortic stenosis computed tomography extracellular volume fraction Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/7922af1df2534575b67b9e6188b1353a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:7922af1df2534575b67b9e6188b1353a
record_format	dspace
spelling	oai:doaj.org-article:7922af1df2534575b67b9e6188b1353a2021-11-23T11:36:34ZPrognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis10.1161/JAHA.120.0206552047-9980https://doaj.org/article/7922af1df2534575b67b9e6188b1353a2021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.120.020655https://doaj.org/toc/2047-9980Background Myocardial extracellular volume fraction (ECV), measured by cardiac magnetic resonance imaging, is a useful prognostic marker for patients who have undergone aortic valve replacement (AVR) for aortic stenosis. However, the prognostic significance of ECV measurements based on computed tomography (CT) is unclear. This study evaluated the association between ECV measured with dual‐energy CT and clinical outcomes in patients with aortic stenosis who underwent transcatheter or surgical AVR. Methods and Results We retrospectively enrolled 95 consecutive patients (age, 84.0±5.0 years; 75% women) with severe aortic stenosis who underwent preprocedural CT for transcatheter AVR planning. ECV was measured using iodine density images obtained by delayed enhancement dual‐energy CT. The primary end point was a composite outcome of all‐cause death and hospitalization for heart failure after AVR. The mean ECV measured with CT was 28.1±3.8%. During a median follow‐up of 2.6 years, 22 composite outcomes were observed, including 15 all‐cause deaths and 11 hospitalizations for heart failure. In Kaplan‐Meier analysis, the high ECV group (≥27.8% [median value]) had significantly higher rates of composite outcomes than the low ECV group (<27.8%) (log‐rank test, P=0.012). ECV was the only independent predictor of adverse outcomes on multivariable Cox regression analysis (hazards ratio, 1.25; 95% CI, 1.10‒1.41; P<0.001). Conclusions Myocardial ECV measured with dual‐energy CT in patients who underwent aortic valve intervention was an independent predictor of adverse outcomes after AVR.Masataka SuzukiTakayoshi TobaYu IzawaHiroshi FujitaKeisuke MiwaYu TakahashiHiroyuki TohHiroyuki KawamoriHiromasa OtakeHidekazu TanakaSei FujiwaraYoshiaki WatanabeAtsushi K. KonoKenji OkadaKen‐ichi HirataWileyarticleaortic stenosiscomputed tomographyextracellular volume fractionDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	aortic stenosis computed tomography extracellular volume fraction Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	aortic stenosis computed tomography extracellular volume fraction Diseases of the circulatory (Cardiovascular) system RC666-701 Masataka Suzuki Takayoshi Toba Yu Izawa Hiroshi Fujita Keisuke Miwa Yu Takahashi Hiroyuki Toh Hiroyuki Kawamori Hiromasa Otake Hidekazu Tanaka Sei Fujiwara Yoshiaki Watanabe Atsushi K. Kono Kenji Okada Ken‐ichi Hirata Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis
description	Background Myocardial extracellular volume fraction (ECV), measured by cardiac magnetic resonance imaging, is a useful prognostic marker for patients who have undergone aortic valve replacement (AVR) for aortic stenosis. However, the prognostic significance of ECV measurements based on computed tomography (CT) is unclear. This study evaluated the association between ECV measured with dual‐energy CT and clinical outcomes in patients with aortic stenosis who underwent transcatheter or surgical AVR. Methods and Results We retrospectively enrolled 95 consecutive patients (age, 84.0±5.0 years; 75% women) with severe aortic stenosis who underwent preprocedural CT for transcatheter AVR planning. ECV was measured using iodine density images obtained by delayed enhancement dual‐energy CT. The primary end point was a composite outcome of all‐cause death and hospitalization for heart failure after AVR. The mean ECV measured with CT was 28.1±3.8%. During a median follow‐up of 2.6 years, 22 composite outcomes were observed, including 15 all‐cause deaths and 11 hospitalizations for heart failure. In Kaplan‐Meier analysis, the high ECV group (≥27.8% [median value]) had significantly higher rates of composite outcomes than the low ECV group (<27.8%) (log‐rank test, P=0.012). ECV was the only independent predictor of adverse outcomes on multivariable Cox regression analysis (hazards ratio, 1.25; 95% CI, 1.10‒1.41; P<0.001). Conclusions Myocardial ECV measured with dual‐energy CT in patients who underwent aortic valve intervention was an independent predictor of adverse outcomes after AVR.
format	article
author	Masataka Suzuki Takayoshi Toba Yu Izawa Hiroshi Fujita Keisuke Miwa Yu Takahashi Hiroyuki Toh Hiroyuki Kawamori Hiromasa Otake Hidekazu Tanaka Sei Fujiwara Yoshiaki Watanabe Atsushi K. Kono Kenji Okada Ken‐ichi Hirata
author_facet	Masataka Suzuki Takayoshi Toba Yu Izawa Hiroshi Fujita Keisuke Miwa Yu Takahashi Hiroyuki Toh Hiroyuki Kawamori Hiromasa Otake Hidekazu Tanaka Sei Fujiwara Yoshiaki Watanabe Atsushi K. Kono Kenji Okada Ken‐ichi Hirata
author_sort	Masataka Suzuki
title	Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis
title_short	Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis
title_full	Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis
title_fullStr	Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis
title_full_unstemmed	Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis
title_sort	prognostic impact of myocardial extracellular volume fraction assessment using dual‐energy computed tomography in patients treated with aortic valve replacement for severe aortic stenosis
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/7922af1df2534575b67b9e6188b1353a
work_keys_str_mv	AT masatakasuzuki prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT takayoshitoba prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT yuizawa prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT hiroshifujita prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT keisukemiwa prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT yutakahashi prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT hiroyukitoh prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT hiroyukikawamori prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT hiromasaotake prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT hidekazutanaka prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT seifujiwara prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT yoshiakiwatanabe prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT atsushikkono prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT kenjiokada prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis AT kenichihirata prognosticimpactofmyocardialextracellularvolumefractionassessmentusingdualenergycomputedtomographyinpatientstreatedwithaorticvalvereplacementforsevereaorticstenosis
_version_	1718416773093523456

Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis

Ejemplares similares