Epicardial adipose tissue as an independent predictor of long-term outcome in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement
2024 | journal article. A publication with affiliation to the University of Göttingen.
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Epicardial adipose tissue as an independent predictor of long-term outcome in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement
Schulz, A.; Beuthner, B. E.; Böttiger, Z. M.; Gersch, S. S.; Lange, T.; Gronwald, J. & Evertz, R. et al. (2024)
Clinical Research in Cardiology,. DOI: https://doi.org/10.1007/s00392-024-02387-5
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- Authors
- Schulz, Alexander; Beuthner, Bo E.; Böttiger, Zoé M.; Gersch, Svante S.; Lange, Torben; Gronwald, Judith; Evertz, Ruben; Backhaus, Sören J.; Kowallick, Johannes T.; Hasenfuß, Gerd; Schuster, Andreas
- Abstract
- Abstract Background Accurate risk stratification is important to improve patient selection and outcome of patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). As epicardial adipose tissue (EAT) is discussed to be involved in cardiovascular disease, it could be useful as a marker of poor prognosis in patients with severe AS undergoing TAVR. Methods A total of 416 patients diagnosed with severe AS by transthoracic echocardiography were assigned for TAVR and enrolled for systematic assessment. Patients underwent clinical surveys and 5-year long-term follow-up, with all-cause mortality as the primary endpoint. EAT volume was quantified on pre-TAVR planning CTs. Patients were retrospectively dichotomized at the median of 74 cm 3 of EAT into groups with low EAT and high EAT volumes. Mortality rates were compared using Kaplan-Meyer plots and uni- and multivariable cox regression analyses. Results A total number of 341 of 416 patients (median age 80.9 years, 45% female) were included in the final analysis. Patients with high EAT volumes had similar short-term outcome ( p = 0.794) but significantly worse long-term prognosis ( p = 0.023) compared to patients with low EAT volumes. Increased EAT volumes were associated with worse long-term outcome (HR1.59; p = 0.031) independently from concomitant cardiovascular risk factors, general type of AS, and functional echocardiography parameters of AS severity (HR1.69; p = 0.013). Conclusion Increased EAT volume is an independent predictor of all-cause mortality in patients with severe AS undergoing TAVR. It can be easily obtained from pre-TAVR planning CTs and may thus qualify as a novel marker to improve prognostication and management of patient with severe AS. Trial registration DRKS, DRKS00024479. Graphical abstract AS, aortic stenosis; TAVR, transcatheter aortic valve replacement; EAT, epicardial adipose tissue
- Issue Date
- 2024
- Journal
- Clinical Research in Cardiology
- Project
- SFB 1002: Modulatorische Einheiten bei Herzinsuffizienz
SFB 1002 | D01: Erholung aus der Herzinsuffizienz – Einfluss von Fibrose und Transkriptionssignatur - Working Group
- RG Backhaus
RG Hasenfuß (Transition zur Herzinsuffizienz) - ISSN
- 1861-0684
- eISSN
- 1861-0692
- Language
- English
- Sponsor
- Deutsche Forschungsgemeinschaft http://dx.doi.org/10.13039/501100001659
Herzzentrum Göttingen