PMID- 31826675
OWN - NLM
STAT- MEDLINE
DCOM- 20200615
LR  - 20200615
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Linking)
VI  - 12
IP  - 12
DP  - 2019 Dec
TI  - Hemodynamics and Subclinical Leaflet Thrombosis in Low-Risk Patients Undergoing 
      Transcatheter Aortic Valve Replacement.
PG  - e009608
LID - 10.1161/CIRCIMAGING.119.009608 [doi]
AB  - BACKGROUND: This analysis evaluated echocardiographic predictors of 
      hypoattenuated leaflet thickening (HALT) in low-risk patients undergoing 
      transcatheter aortic valve replacement and assessed 1-year clinical and 
      hemodynamic consequences. HALT by computed tomography may be associated with 
      early valve degeneration and increased neurological events. METHODS: 
      Echocardiograms were performed at baseline, discharge, 30 days, and 1 year 
      post-procedure. Four-dimensional contrast-enhanced computed tomography assessed 
      HALT at 30 days. Independent core laboratories analyzed images. Doppler 
      hemodynamic parameters were tested in a univariable regression model to identify 
      HALT predictors. One-year clinical and hemodynamic outcomes were compared between 
      HALT (+) and (-) patients. RESULTS: Analysis included 170 patients with Sapien 3 
      valves and diagnostic 30-day computed tomographies, of whom 27 (16%) had HALT. 
      Baseline characteristics were similar between groups. After transcatheter aortic 
      valve replacement, aortic flow was nonsignificantly reduced in patients who 
      developed HALT. Regression analysis did not show significant association between 
      baseline or discharge valve hemodynamics and development of HALT at 30 days. 
      Patients with HALT had smaller aortic valve areas (1.4+/-0.4 versus 1.7+/-0.5 cm(2); 
      P=0.018) and Doppler velocity index (0.4+/-0.1 versus 0.5+/-0.1; P=0.003) than those 
      without HALT at 30 days but not at 1 year. There was no difference in aortic mean 
      gradient at 30 days. There was no difference between the groups in New York Heart 
      Association class, 6-minute walk distance, and mortality at 1 year. CONCLUSIONS: 
      There were no early hemodynamic predictors of HALT. At 30 days, patients with 
      HALT had worse valve hemodynamics than those without HALT, but hemodynamic and 
      clinical outcomes at 1 year were similar. CLINICAL TRIAL REGISTRATION: URL: 
      http://www.clinicaltrials.gov. Unique identifier: NCT02628899.
FAU - Khan, Jaffar M
AU  - Khan JM
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
AD  - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and 
      Blood Institute, National Institutes of Health, Bethesda, MD (J.M.K., T.R.).
FAU - Rogers, Toby
AU  - Rogers T
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
AD  - Cardiovascular Branch, Division of Intramural Research, National Heart Lung and 
      Blood Institute, National Institutes of Health, Bethesda, MD (J.M.K., T.R.).
FAU - Waksman, Ron
AU  - Waksman R
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
FAU - Torguson, Rebecca
AU  - Torguson R
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
FAU - Weissman, Gaby
AU  - Weissman G
AD  - Department of Cardiology (G.W.), Medstar Washington Hospital Center, DC.
FAU - Medvedofsky, Diego
AU  - Medvedofsky D
AD  - MedStar Health Research Institute (D.M., F.M.A.), Medstar Washington Hospital 
      Center, DC.
FAU - Craig, Paige E
AU  - Craig PE
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
FAU - Zhang, Cheng
AU  - Zhang C
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
FAU - Gordon, Paul
AU  - Gordon P
AD  - Division of Cardiology, The Miriam Hospital, Providence, Rhode Island (P.G.).
FAU - Ehsan, Afshin
AU  - Ehsan A
AD  - Division of Cardiothoracic Surgery, Lifespan Cardiovascular Institute, 
      Providence, Rhode Island (A.E.).
FAU - Wilson, Sean R
AU  - Wilson SR
AD  - Department of Medicine (S.R.W.), The Valley Hospital, Ridgewood, NJ.
FAU - Goncalves, John
AU  - Goncalves J
AD  - Cardiac Surgery Program (J.G.), The Valley Hospital, Ridgewood, NJ.
FAU - Levitt, Robert
AU  - Levitt R
AD  - Department of Cardiology (R.L.), Henrico Doctors' Hospital, Richmond, Virginia.
FAU - Hahn, Chiwon
AU  - Hahn C
AD  - Department of Cardiothoracic Surgery (C.W.), Henrico Doctors' Hospital, Richmond, 
      Virginia.
FAU - Parikh, Puja
AU  - Parikh P
AD  - Department of Medicine (P.P.), Stony Brook Hospital, NY.
FAU - Bilfinger, Thomas
AU  - Bilfinger T
AD  - Department of Surgery (T.B.), Stony Brook Hospital, NY.
FAU - Butzel, David
AU  - Butzel D
AD  - Cardiovascular Service Line, Maine Medical Center, Portland (D.B., S.B.).
FAU - Buchanan, Scott
AU  - Buchanan S
AD  - Cardiovascular Service Line, Maine Medical Center, Portland (D.B., S.B.).
FAU - Hanna, Nicholas
AU  - Hanna N
AD  - St John Heart Institute Cardiovascular Consultants, St John Health System, Tulsa, 
      Oklahoma (N.H.).
FAU - Garrett, Robert
AU  - Garrett R
AD  - St John Clinic Cardiovascular Surgery, St John Heart Institute Cardiovascular 
      Consultants, St John Health System, Tulsa, Oklahoma (R.G.).
FAU - Shults, Christian
AU  - Shults C
AD  - Department of Cardiac Surgery (C.S.), Medstar Washington Hospital Center, DC.
FAU - Garcia-Garcia, Hector M
AU  - Garcia-Garcia HM
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
FAU - Kolm, Paul
AU  - Kolm P
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
FAU - Satler, Lowell F
AU  - Satler LF
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
FAU - Buchbinder, Maurice
AU  - Buchbinder M
AD  - Foundation for Cardiovascular Medicine, Stanford University, California (M.B.).
FAU - Ben-Dor, Itsik
AU  - Ben-Dor I
AD  - Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., 
      H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC.
FAU - Asch, Federico M
AU  - Asch FM
AD  - MedStar Health Research Institute (D.M., F.M.A.), Medstar Washington Hospital 
      Center, DC.
LA  - eng
SI  - ClinicalTrials.gov/NCT02628899
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20191212
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
SB  - IM
CIN - Circ Cardiovasc Imaging. 2019 Dec;12(12):e010151. PMID: 31826676
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/diagnostic imaging/physiopathology/*surgery
MH  - Aortic Valve Stenosis/diagnostic imaging/physiopathology/*surgery
MH  - Echocardiography, Doppler
MH  - Female
MH  - Four-Dimensional Computed Tomography
MH  - *Heart Valve Prosthesis
MH  - *Hemodynamics
MH  - Humans
MH  - Male
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Prosthesis Failure
MH  - Risk Assessment
MH  - Risk Factors
MH  - Thrombosis/diagnostic imaging/*etiology/physiopathology
MH  - Time Factors
MH  - Transcatheter Aortic Valve Replacement/*adverse effects/*instrumentation
MH  - Treatment Outcome
MH  - United States
OTO - NOTNLM
OT  - aortic valve
OT  - echocardiography
OT  - hemodynamics
OT  - regression analysis
OT  - transcatheter aortic valve replacement
EDAT- 2019/12/13 06:00
MHDA- 2020/06/17 06:00
CRDT- 2019/12/13 06:00
PHST- 2019/12/13 06:00 [entrez]
PHST- 2019/12/13 06:00 [pubmed]
PHST- 2020/06/17 06:00 [medline]
AID - 10.1161/CIRCIMAGING.119.009608 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2019 Dec;12(12):e009608. doi: 
      10.1161/CIRCIMAGING.119.009608. Epub 2019 Dec 12.