From the BHF/Centre for Cardiovascular Science (T.A.P., T.R.G.C., W.S.A.J., P.D.A., D.E.N., M.R.D.), Clinical Research Imaging Centre, Queen's Medical Research Institute (C.L., E.J.R.V.B., A.F.), and Edinburgh Clinical Trials Unit, Western General Hospital (L.F.), University of Edinburgh, United Kingdom; Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York (P.R., Z.A.F.); Guy's and St Thomas' Hospitals NHS Foundation Trust, London, United Kingdom (B.P.); Institute for Education in Medical and Dental Sciences, University of Aberdeen, United Kingdom (A.R.D.); Division of Cardiovascular Medicine, University of Cambridge, United Kingdom (J.H.F.R.); and Wellcome Trust Clinical Research Facility, Western General Hospital Edinburgh, United Kingdom (S.T.).
Published: October 2016
AI Article Synopsis
Article Abstract
Background: 18F-Fluoride positron emission tomography (PET) and computed tomography (CT) can measure disease activity and progression in aortic stenosis. Our objectives were to optimize the methodology, analysis, and scan-rescan reproducibility of aortic valve 18F-fluoride PET-CT imaging.
Methods And Results: Fifteen patients with aortic stenosis underwent repeated 18F-fluoride PET-CT. We compared nongated PET and noncontrast CT, with a modified approach that incorporated contrast CT and ECG-gated PET. We explored a range of image analysis techniques, including estimation of blood-pool activity at differing vascular sites and a most diseased segment approach. Contrast-enhanced ECG-gated PET-CT permitted localization of 18F-fluoride uptake to individual valve leaflets. Uptake was most commonly observed at sites of maximal mechanical stress: the leaflet tips and the commissures. Scan-rescan reproducibility was markedly improved using enhanced analysis techniques leading to a reduction in percentage error from ±63% to ±10% (tissue to background ratio MDS mean of 1.55, bias -0.05, limits of agreement -0·20 to +0·11).
Conclusions: Optimized 18F-fluoride PET-CT allows reproducible localization of calcification activity to different regions of the aortic valve leaflet and commonly to areas of increased mechanical stress. This technique holds major promise in improving our understanding of the pathophysiology of aortic stenosis and as a biomarker end point in clinical trials of novel therapies.
Introduction And Objectives: The Valve Academic Research Consortium (VARC)-3 definition of the early safety (ES) composite endpoint after transcatheter aortic valve replacement (TAVR) lacks clinical validation. The aim of this study was to determine the incidence, predictors, and clinical impact of ES after TAVR as defined by VARC-3 criteria.
Methods: We performed a multicenter study including 10 078 patients with severe aortic stenosis undergoing transarterial TAVR.
Background: Survival after transcatheter aortic valve replacement (TAVR) has markedly increased. Thus, other comorbidities will intersect patient trajectories and challenge follow-up.
Objectives: The aim of this study was to describe patient characteristics and hospitalizations at end of life to further improve the quality of life for patients undergoing TAVR.
Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lübeck/Kiel, Lübeck, Germany; BG University Hospital Bergmannsheil, Bochum, Germany.
Background: Transradial secondary access (TR-SA) may serve as an alternative to the traditional femoral secondary access (TF-SA) for pigtail placement in transcatheter aortic valve replacement (TAVR).
Objectives: The aim of this study was to assess the incidence of secondary access-related vascular complications after TR-SA or TF-SA in TAVR.
Methods: The PULSE (Plug or sUture based vascuLar cloSurE after TAVR) registry retrospectively evaluated data of 10,120 patients who underwent transfemoral TAVR at 10 heart centers from 2016 to 2021.
Background: Subclinical leaflet thrombosis (SLT) is a common complication after transcatheter aortic valve replacement (TAVR). Multidimensional CT (MDCT) is the main imaging mortality for the diagnosis of SLT but it enhances the risk of contrast-induced nephropathy. Our study aimed to use an innovative wearable acoustic cardiography (ACG) device to diagnose SLT as an alternative option.
