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Predictors of calcification distribution in severe tricuspid aortic valve stenosis
We investigated aortic valve calcification (AVC) distribution and predictors for leaflet calcification patterns in patients with severe tricuspid aortic valve stenosis undergoing transcatheter aortic valve replacement (TAVR). Patients undergoing routine multi-sliced computed tomography (MSCT) for pr...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Netherlands
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390394/ https://www.ncbi.nlm.nih.gov/pubmed/33877483 http://dx.doi.org/10.1007/s10554-021-02248-6 |
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author | Piayda, Kerstin Dannenberg, Lisa Zako, Saif Maier, Oliver Bosbach, Georg Polzin, Amin Afzal, Shazia Jung, Christian Westenfeld, Ralf Kelm, Malte Zeus, Tobias Veulemans, Verena |
author_facet | Piayda, Kerstin Dannenberg, Lisa Zako, Saif Maier, Oliver Bosbach, Georg Polzin, Amin Afzal, Shazia Jung, Christian Westenfeld, Ralf Kelm, Malte Zeus, Tobias Veulemans, Verena |
author_sort | Piayda, Kerstin |
collection | PubMed |
description | We investigated aortic valve calcification (AVC) distribution and predictors for leaflet calcification patterns in patients with severe tricuspid aortic valve stenosis undergoing transcatheter aortic valve replacement (TAVR). Patients undergoing routine multi-sliced computed tomography (MSCT) for procedural planning were enrolled. MSCT data were transferred to a dedicated workstation for evaluation (3mensio Structural Heart™, Pie Medical Imaging BV, Maastricht, The Netherlands) and analyzed. Participants were separated into asymmetrical (AC) and symmetrical (SC) leaflet calcification and potential predictors for calcification distribution were identified with univariate and multivariate regression analysis. 567 Participants with severe tricuspid AS were divided into asymmetrical (AC, n = 443; 78.1%) and symmetrical (SC, n = 124; 21.9%) AVC. In AC, the non-coronary cusp was the most calcified cusp (n = 238; 57.7%). SC is more common in females (AC/SC: 49.2% vs. 67.7%; p < 0.0001). AVC was more severe in patients with AC, who also have larger aortic root dimensions. Multivariate analysis depicted, inter alia, left ventricular outflow tract (LVOT) calcification < 25 Agatston units (OR 1.81 [1.09–3.00], p = 0.021), a mean pressure gradient < 36 mmHg (OR 1.77 [1.03–3.05], p = 0.039), and an annulo-apical angle > 67° (OR 1.68 [1.00–2.80], p = 0.049) as predictors for SC, although with only moderate predictive value. Data from this retrospective analysis indicate that SC occurs more frequently in females. The cumulative leaflet calcification burden is higher in patients with AC, who also present with larger aortic root dimensions. The predictive value for prominent calcification of different aortic valve cusps in AC patients was only low to moderate. Trial registration number: NCT01805739. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10554-021-02248-6. |
format | Online Article Text |
id | pubmed-8390394 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-83903942021-09-14 Predictors of calcification distribution in severe tricuspid aortic valve stenosis Piayda, Kerstin Dannenberg, Lisa Zako, Saif Maier, Oliver Bosbach, Georg Polzin, Amin Afzal, Shazia Jung, Christian Westenfeld, Ralf Kelm, Malte Zeus, Tobias Veulemans, Verena Int J Cardiovasc Imaging Original Paper We investigated aortic valve calcification (AVC) distribution and predictors for leaflet calcification patterns in patients with severe tricuspid aortic valve stenosis undergoing transcatheter aortic valve replacement (TAVR). Patients undergoing routine multi-sliced computed tomography (MSCT) for procedural planning were enrolled. MSCT data were transferred to a dedicated workstation for evaluation (3mensio Structural Heart™, Pie Medical Imaging BV, Maastricht, The Netherlands) and analyzed. Participants were separated into asymmetrical (AC) and symmetrical (SC) leaflet calcification and potential predictors for calcification distribution were identified with univariate and multivariate regression analysis. 567 Participants with severe tricuspid AS were divided into asymmetrical (AC, n = 443; 78.1%) and symmetrical (SC, n = 124; 21.9%) AVC. In AC, the non-coronary cusp was the most calcified cusp (n = 238; 57.7%). SC is more common in females (AC/SC: 49.2% vs. 67.7%; p < 0.0001). AVC was more severe in patients with AC, who also have larger aortic root dimensions. Multivariate analysis depicted, inter alia, left ventricular outflow tract (LVOT) calcification < 25 Agatston units (OR 1.81 [1.09–3.00], p = 0.021), a mean pressure gradient < 36 mmHg (OR 1.77 [1.03–3.05], p = 0.039), and an annulo-apical angle > 67° (OR 1.68 [1.00–2.80], p = 0.049) as predictors for SC, although with only moderate predictive value. Data from this retrospective analysis indicate that SC occurs more frequently in females. The cumulative leaflet calcification burden is higher in patients with AC, who also present with larger aortic root dimensions. The predictive value for prominent calcification of different aortic valve cusps in AC patients was only low to moderate. Trial registration number: NCT01805739. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10554-021-02248-6. Springer Netherlands 2021-04-20 2021 /pmc/articles/PMC8390394/ /pubmed/33877483 http://dx.doi.org/10.1007/s10554-021-02248-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Paper Piayda, Kerstin Dannenberg, Lisa Zako, Saif Maier, Oliver Bosbach, Georg Polzin, Amin Afzal, Shazia Jung, Christian Westenfeld, Ralf Kelm, Malte Zeus, Tobias Veulemans, Verena Predictors of calcification distribution in severe tricuspid aortic valve stenosis |
title | Predictors of calcification distribution in severe tricuspid aortic valve stenosis |
title_full | Predictors of calcification distribution in severe tricuspid aortic valve stenosis |
title_fullStr | Predictors of calcification distribution in severe tricuspid aortic valve stenosis |
title_full_unstemmed | Predictors of calcification distribution in severe tricuspid aortic valve stenosis |
title_short | Predictors of calcification distribution in severe tricuspid aortic valve stenosis |
title_sort | predictors of calcification distribution in severe tricuspid aortic valve stenosis |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390394/ https://www.ncbi.nlm.nih.gov/pubmed/33877483 http://dx.doi.org/10.1007/s10554-021-02248-6 |
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