PMID- 35407425
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220419
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 11
IP  - 7
DP  - 2022 Mar 25
TI  - Performance of Computed Tomography Angiography (CTA) for the Diagnosis of 
      Hypo-Attenuated Leaflet Thickening (HALT).
LID - 10.3390/jcm11071817 [doi]
LID - 1817
AB  - (1) Background: Early hypo-attenuated leaflet thickening (HALT) is diagnosed by 
      computed tomography angiography (CTA) in approximately 15% of patients undergoing 
      transcatheter aortic valve replacement (TAVR). We sought to investigate the 
      diagnostic performance of CTA for the diagnosis of HALT, focusing on timing data 
      assessment within the cardiac cycle. (2) Methods: The study enrolled 50 patients 
      with and 50 without HALT with available post-TAVR-CTA. The primary objective was 
      to compare the diagnostic performance of CTA readings at specific intervals and 
      time points during the cardiac cycle (entire systole, entire diastole, 
      end-systole, and mid-diastole) versus gold standard (consensus reading by two 
      observers based on multiphase full cardiac cycle data sets). (3) Results: 100 
      CTAs were independently analysed by two observers blinded to clinical 
      characteristics of the study population and the results from the gold standard 
      reading. Sensitivity and specificity for the diagnosis of HALT were 84%/94% in 
      systole, 87%/92% in diastole, 78%/95% at end-systole, and 80%/94% at 
      mid-diastole. End-systole had the highest positive predictive value (0.88) and 
      positive likelihood ratio (36). Cohen's kappa for interobserver reliability was 
      0.715 in systole, 0.578 in diastole, 0.650 at end-systole, and 0.517 at 
      mid-diastole. (4) Conclusion: Limiting CTA reading to distinct intervals or time 
      points during the cardiac cycle has good specificity but lowers sensitivity. For 
      a reliable diagnosis of HALT, data sets from a multiphase CTA covering the entire 
      cardiac cycle should be analysed. A double reader approach would be desirable in 
      further studies investigating HALT.
FAU - Hein, Manuel
AU  - Hein M
AUID- ORCID: 0000-0003-0430-7184
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg, 79106 
      Freiburg, Germany.
FAU - Breitbart, Philipp
AU  - Breitbart P
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg, 79106 
      Freiburg, Germany.
FAU - Minners, Jan
AU  - Minners J
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg, 79106 
      Freiburg, Germany.
FAU - Blanke, Philipp
AU  - Blanke P
AD  - Department of Radiology, St. Paul's Hospital, University of British Columbia, 
      Vancouver, BC V6Z1Y6, Canada.
FAU - Schoechlin, Simon
AU  - Schoechlin S
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg, 79106 
      Freiburg, Germany.
FAU - Schlett, Christopher
AU  - Schlett C
AUID- ORCID: 0000-0002-1576-1481
AD  - Department of Diagnostic and Interventional Radiology, Medical Center-University 
      of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, 
      Germany.
FAU - Krauss, Tobias
AU  - Krauss T
AD  - Department of Diagnostic and Interventional Radiology, Medical Center-University 
      of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, 
      Germany.
FAU - Soschynski, Martin
AU  - Soschynski M
AD  - Department of Diagnostic and Interventional Radiology, Medical Center-University 
      of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, 
      Germany.
FAU - Neumann, Franz-Josef
AU  - Neumann FJ
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg, 79106 
      Freiburg, Germany.
FAU - Ruile, Philipp
AU  - Ruile P
AD  - Department of Cardiology & Angiology II, University Heart Center Freiburg, 79106 
      Freiburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20220325
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC8999481
OTO - NOTNLM
OT  - TAVI
OT  - TAVR
OT  - computed tomography
OT  - hypo-attenuated leaflet thickening
OT  - leaflet thrombosis
OT  - post-TAVR-CTA
COIS- P. Blanke, consultant for Edwards Lifesciences and Circle Cardiovascular Imaging; 
      provides CT core lab services for Edwards Lifesciences, Medtronic, Neovasc, and 
      Tendyne Holdings, for which he receives no direct compensation. F.-J. Neumann: 
      Grants to institution from Boston Scientific, Biotronik, Medtronic, Edwards 
      Lifescience, Abbott Vascular. M. Hein, P. Breitbart, S. Schoechlin, J. Minners, 
      C. L. Schlett, T.Krauss, M. Soschynski, Philipp Ruile have nothing to declare.
EDAT- 2022/04/13 06:00
MHDA- 2022/04/13 06:01
PMCR- 2022/03/25
CRDT- 2022/04/12 01:07
PHST- 2022/02/08 00:00 [received]
PHST- 2022/03/18 00:00 [revised]
PHST- 2022/03/23 00:00 [accepted]
PHST- 2022/04/12 01:07 [entrez]
PHST- 2022/04/13 06:00 [pubmed]
PHST- 2022/04/13 06:01 [medline]
PHST- 2022/03/25 00:00 [pmc-release]
AID - jcm11071817 [pii]
AID - jcm-11-01817 [pii]
AID - 10.3390/jcm11071817 [doi]
PST - epublish
SO  - J Clin Med. 2022 Mar 25;11(7):1817. doi: 10.3390/jcm11071817.