Epicardial adipose tissue as an independent predictor of long-term outcome in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement

被引：8

作者：

Schulz, Alexander ^{[1
,2
]}

Beuthner, Bo E. ^{[1
,2
]}

Boettiger, Zoe M. ^{[1
,2
]}

Gersch, Svante S. ^{[1
,2
]}

Lange, Torben ^{[1
,2
]}

Gronwald, Judith ^{[1
,2
]}

Evertz, Ruben ^{[1
,2
]}

Backhaus, Soeren J. ^{[1
,2
,3
]}

Kowallick, Johannes T. ^{[2
,4
]}

Hasenfuss, Gerd ^{[1
,2
]}

Schuster, Andreas ^{[1
,2
,3
]}

机构：

[1] Georg August Univ, Univ Med Ctr Gottingen, Dept Cardiol & Pneumol, Gottingen, Germany

[2] German Ctr Cardiovasc Res DZHK, Partner Site Gottingen, Gottingen, Germany

[3] Kings Coll London, Sch Biomed Engn & Imaging Sci, London, England

[4] Georg August Univ, Univ Med Ctr Gottingen, Inst Diagnost & Intervent Radiol, Gottingen, Germany

来源：

CLINICAL RESEARCH IN CARDIOLOGY | 2024年

关键词：

Epicardial adipose tissue; Transcatheter aortic valve replacement; Risk prediction; Computed tomography; Long-term outcome; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; RISK; IMPLANTATION; IMPACT; FAT; RECOMMENDATIONS; CALCIFICATION; UPDATE;

D O I：

10.1007/s00392-024-02387-5

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundAccurate risk stratification is important to improve patient selection and outcome of patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). As epicardial adipose tissue (EAT) is discussed to be involved in cardiovascular disease, it could be useful as a marker of poor prognosis in patients with severe AS undergoing TAVR.MethodsA total of 416 patients diagnosed with severe AS by transthoracic echocardiography were assigned for TAVR and enrolled for systematic assessment. Patients underwent clinical surveys and 5-year long-term follow-up, with all-cause mortality as the primary endpoint. EAT volume was quantified on pre-TAVR planning CTs. Patients were retrospectively dichotomized at the median of 74 cm3 of EAT into groups with low EAT and high EAT volumes. Mortality rates were compared using Kaplan-Meyer plots and uni- and multivariable cox regression analyses.ResultsA total number of 341 of 416 patients (median age 80.9 years, 45% female) were included in the final analysis. Patients with high EAT volumes had similar short-term outcome (p = 0.794) but significantly worse long-term prognosis (p = 0.023) compared to patients with low EAT volumes. Increased EAT volumes were associated with worse long-term outcome (HR1.59; p = 0.031) independently from concomitant cardiovascular risk factors, general type of AS, and functional echocardiography parameters of AS severity (HR1.69; p = 0.013).ConclusionIncreased EAT volume is an independent predictor of all-cause mortality in patients with severe AS undergoing TAVR. It can be easily obtained from pre-TAVR planning CTs and may thus qualify as a novel marker to improve prognostication and management of patient with severe AS.Trial registrationDRKS, DRKS00024479.Graphical abstractAS, aortic stenosis; TAVR, transcatheter aortic valve replacement; EAT, epicardial adipose tissue

引用

页数：12

共 57 条

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