PMID- 35680190
OWN - NLM
STAT- MEDLINE
DCOM- 20220613
LR  - 20220706
IS  - 1876-7605 (Electronic)
IS  - 1936-8798 (Linking)
VI  - 15
IP  - 11
DP  - 2022 Jun 13
TI  - Long-Term Follow-Up of Hypoattenuated Leaflet Thickening After Transcatheter 
      Aortic Valve Replacement.
PG  - 1113-1122
LID - S1936-8798(22)00835-4 [pii]
LID - 10.1016/j.jcin.2022.04.018 [doi]
AB  - BACKGROUND: Early hypoattenuated leaflet thickening (HALT) occurs in at least 10% 
      of all transcatheter aortic valve replacement (TAVR) patients. The long-term 
      prognostic impact of HALT is uncertain. OBJECTIVES: The aim of this study was to 
      assess the long-term risk of early HALT post-TAVR. METHODS: We report outcome 
      data from our prospective observational registry with post-TAVR computed 
      tomography angiography performed between May 2012 and December 2017. The outcomes 
      were survival, cardiovascular mortality, ischemic cerebrovascular events, and 
      symptomatic hemodynamic valve deterioration. RESULTS: Early HALT was diagnosed in 
      115 (16.0%) of 804 patients. During a median follow-up of 3.25 years, survival 
      rates did not differ significantly between patients with and without HALT 
      (Kaplan-Meier 3-year estimates for survival 70.1% vs 74.0%, P = 0.597). The 
      3-year cardiovascular mortality rate was 13.2% versus 11.3% (with vs without 
      HALT, P = 0.733). The 3-year event rate for cerebrovascular events was 2.0% 
      versus 4.4% (with vs without HALT, P = 0.246), and the 3-year event rate of 
      symptomatic hemodynamic valve deterioration was 9.4% versus 1.5% (with vs without 
      HALT, P < 0.001). Multivariable analysis revealed the following predictors of 
      symptomatic hemodynamic valve deterioration: HALT (HR: 6.10; 95% CI: 2.59-14.29; 
      P < 0.001), the mixed valve-type group (HR: 6.51; 95% CI: 2.38-17.81; P < 0.001), 
      and prosthesis diameter (HR valve size per 3 mm [HR: 0.37; 95% CI: 0.17-0.79]; P 
      = 0.011). CONCLUSIONS: During a median follow-up of more than 3 years, HALT was 
      not associated with mortality or cerebrovascular events. However, we observed an 
      association of HALT with symptomatic hemodynamic valve deterioration.
CI  - Copyright (c) 2022 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Hein, Manuel
AU  - Hein M
AD  - Department of Cardiology and Angiology, University Heart Center, Freiburg-Bad 
      Krozingen, Germany. Electronic address: manuel.hein@uniklinik-freiburg.de.
FAU - Schoechlin, Simon
AU  - Schoechlin S
AD  - Department of Cardiology and Angiology, University Heart Center, Freiburg-Bad 
      Krozingen, Germany.
FAU - Schulz, Undine
AU  - Schulz U
AD  - Department of Cardiology and Angiology, University Heart Center, Freiburg-Bad 
      Krozingen, Germany.
FAU - Minners, Jan
AU  - Minners J
AD  - Department of Cardiology and Angiology, University Heart Center, Freiburg-Bad 
      Krozingen, Germany.
FAU - Breitbart, Philipp
AU  - Breitbart P
AD  - Department of Cardiology and Angiology, University Heart Center, Freiburg-Bad 
      Krozingen, Germany.
FAU - Lehane, Cornelius
AU  - Lehane C
AD  - Department of Anesthesiology, University Heart Center Freiburg, Bad Krozingen, 
      Freiburg, Germany.
FAU - Neumann, Franz-Josef
AU  - Neumann FJ
AD  - Department of Cardiology and Angiology, University Heart Center, Freiburg-Bad 
      Krozingen, Germany.
FAU - Ruile, Philipp
AU  - Ruile P
AD  - Department of Cardiology and Angiology, University Heart Center, Freiburg-Bad 
      Krozingen, Germany.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - JACC Cardiovasc Interv
JT  - JACC. Cardiovascular interventions
JID - 101467004
SB  - IM
CIN - JACC Cardiovasc Interv. 2022 Jun 13;15(11):1123-1125. PMID: 35680191
MH  - Aortic Valve/diagnostic imaging/surgery
MH  - *Aortic Valve Stenosis/diagnostic imaging/surgery
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis
MH  - Humans
MH  - Risk Factors
MH  - *Transcatheter Aortic Valve Replacement/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - computed tomography angiography
OT  - hemodynamic valve deterioration
OT  - hypoattenuated leaflet thickening
OT  - leaflet thrombosis
OT  - mortality
OT  - stroke
OT  - transcatheter aortic valve replacement
COIS- Funding Support and Author Disclosures Prof Neumann reports that his institution 
      has received research grants, consultancy fees, and speaker honoraria to form 
      Daiichi-Sankyo, AstraZeneca, Sanofi, Bayer, The Medicines Company, Bristol Myers 
      Squibb, Novartis, Roche, Boston Scientific, Biotronik, Medtronic, Edwards, and 
      Ferrer. All other authors have reported that they have no relationships relevant 
      to the contents of this paper to disclose.
EDAT- 2022/06/10 06:00
MHDA- 2022/06/14 06:00
CRDT- 2022/06/09 21:02
PHST- 2021/11/29 00:00 [received]
PHST- 2022/03/01 00:00 [revised]
PHST- 2022/04/05 00:00 [accepted]
PHST- 2022/06/09 21:02 [entrez]
PHST- 2022/06/10 06:00 [pubmed]
PHST- 2022/06/14 06:00 [medline]
AID - S1936-8798(22)00835-4 [pii]
AID - 10.1016/j.jcin.2022.04.018 [doi]
PST - ppublish
SO  - JACC Cardiovasc Interv. 2022 Jun 13;15(11):1113-1122. doi: 
      10.1016/j.jcin.2022.04.018.