Reclassification of aortic stenosis by fusion of echocardiography and computed tomography in low-gradient aortic stenosi
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Neth Heart J https://doi.org/10.1007/s12471-020-01501-2
Reclassification of aortic stenosis by fusion of echocardiography and computed tomography in lowgradient aortic stenosis N. El Faquir · M. E. Vollema · V. Delgado · B. Ren · E. Spitzer · M. Rasheed · Z. Rahhab · M. L. Geleijnse · R. P. J. Budde · P. P. de Jaegere · J. J. Bax · N. M. Van Mieghem
Accepted: 30 September 2020 © The Author(s) 2020
Abstract Background The integration of computed tomography (CT)-derived left ventricular outflow tract area into the echocardiography-derived continuity equation results in the reclassification of a significant proportion of patients with severe aortic stenosis (AS) into moderate AS based on aortic valve area indexed to body surface area determined by fusion imaging (fusion AVAi). The aim of this study was to evaluate AS severity by a fusion imaging technique in patients with low-gradient AS and to compare the clinical impact of reclassified moderate AS versus severe AS. Methods We included 359 consecutive patients who underwent transcatheter aortic valve implantation for low-gradient, severe AS at two academic institutions and created a joint database. The primary endpoint was a composite of all-cause mortality and rehospitalisations for heart failure at 1 year. Results Overall, 35% of the population (n = 126) were reclassified to moderate AS [median fusion AVAi 0.70 (interquartile range, IQR 0.65–0.80) cm2/m2] and severe AS was retained as the classification in 65% [median fusion AVAi 0.49 (IQR 0.43–0.54) cm2/m2]. Lower body mass index, higher logistic EuroSCORE and larger aortic dimensions characterised patients reclassified to moderate AS. Overall, 57% of patients N. El Faquir · B. Ren · E. Spitzer · M. Rasheed · Z. Rahhab · M. L. Geleijnse · P. P. de Jaegere · N. M. Van Mieghem () Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands [email protected] M. E. Vollema · V. Delgado · J. J. Bax Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands R. P. J. Budde Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
had a left ventricular ejection fraction (LVEF)
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