PhD Scientific Days 2024

Cardiovascular Medicine and Research I.

Reclassification From Severe To Moderate Aortic Stenosis Using Hybrid-AVA Technique In TAVR Patients

Előadó neve

Ms. Mohácsi, Fanni

Neptun code

YSCFKL

Előadó munkahelye

Semmelweis University Faculty of Medicine, György Gottsegen Cardiovascular Center

Előadó telefonszáma

06703483012

Előadó e-mail címe

fanni.mohacsi@gokvi.hu

Az előadás címe

Reclassification From Severe To Moderate Aortic Stenosis Using Hybrid-AVA Technique In TAVR Patients

Szerző(k) neve és munkahelye

Fanni Mohácsi¹, Gergely Kovács¹, Mónika Dénes MD, Phd², Márton Kolossváry MD, Phd²

1: Semmelweis University Faculty of Medicine, György Gottsegen Cardiovascular Center
2: György Gottsegen Cardiovascular Center

Bemutatás módja

Szóbeli

Szekció

Cardiovascular Medicine and Research I.

Language of the presentation

English

Preferred session

Cardiovascular Medicine and Research

Összefoglaló szövege

Introduction: Echocardiography (echo) may underestimate aortic valve area (AVA) due to the anatomic shape of leftventricular outflow track (LVOT). Using cardiac CT derived LVOT area in the continuity equation (hybrid-AVA) may result in reclassification of patients with severe aortic stenosis (AS) to moderate AS.
Aims: Our aims were to evaluate the reclassification rate of severe AS to moderate AS by hybrid-AVA, and identify potential predictors of reclassification.
Methods: We retrospectively analyzed consecutive patients with severe AS (echo-AVA < 1cm2) who underwent transcatheter aortic valve replacement (TAVR) in our tertiary cardiovascular center between 06.01.2021-27.02.2023. Hybrid-AVA was calculated by combining CT-based LVOT area and echo Doppler parameters. Patients with hybrid-AVA >1cm2 were reclassified to moderate AS. Bland-Altman analysis was used to evaluate the systematic differences between echo and CT measurements, while logistic regression was used to identify potential predictors of reclassification.
Results: Overall, 706 patients were analyzed (337 men, mean age: 79.1±7=6.9 years). Echo LVOT diameter (20.2±1.9 mm) was significantly smaller than the mean (25.1±2.9 mm) CT-LVOT diameter (<0.0001 for all). Bland-Altman analysis showed that the mean difference between echo-AVA and hybrid-AVA was -0.30±0.19 cm2 (LOA: -0.66; 0.07 cm2). Implementing hybrid-AVA, 200 patients (28.3%) were reclassified into moderate AS. Multivariable logistic regression showed that male sex (aOR: 6.73 [95%CI: 3.62; 13.00]; p<0.0001), ejection fraction (per %; aOR: 0.95 [95%CI: 0.93; 0.97]; p<0.0001), Doppler index (LVOT-VTI/Ao-VTI per 0.1; aOR: 1.50 [95%CI: 1.13;1.28]; p<0.0001), low gradient (<40mmHg; aOR: 1.95 [95%CI: 1.10; 3.46]; p<0.02) and low flow (<35 mL/m2; aOR: 0.37 [95%CI: 0.17; 0.77], p<0.01) significantly increased the odds of reclassification.
Conclusions: The hybrid-AVA calculation led to reclassification of almost 30% of TAVR patients from severe to moderate AS. Male sex, ejection fraction, low flow, low gradient, and Doppler index may be potential predictors of reclassification.
Funding: no fundings used.

University

Semmelweis University

Supervisor

Mónika Dénes MD, Phd, Márton Kolossváry MD, Phd

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

8093

Start

12:15

End

12:25