A systematic review of contrast-enhanced computed tomography calcium scoring methodologies and impact of aortic valve calcium burden on TAVI clinical outcomes.

Autor: Flores-Umanzor E; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada., Keshvara R; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada., Reza S; Toronto General Hospital Research Institute, University Health Network (UHN), Toronto, ON, Canada; Institute for Health Policy, Management, and Evaluation, University of Toronto, ON, Canada., Asghar A; Toronto General Hospital Research Institute, University Health Network (UHN), Toronto, ON, Canada; Institute for Health Policy, Management, and Evaluation, University of Toronto, ON, Canada., Rashidul Anwar M; Toronto General Hospital Research Institute, University Health Network (UHN), Toronto, ON, Canada; Institute for Health Policy, Management, and Evaluation, University of Toronto, ON, Canada., Cepas-Guillen PL; Cardiology Department, Cardiovascular Institute, Hospital Clínic, University of Barcelona, Spain., Osten M; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada., Halankar J; Joint Department of Medical Imaging, Toronto General Hospital, Peter Munk Cardiac Centre, University Health Network, University of Toronto, ON, Canada., Abrahamyan L; Toronto General Hospital Research Institute, University Health Network (UHN), Toronto, ON, Canada; Institute for Health Policy, Management, and Evaluation, University of Toronto, ON, Canada., Horlick E; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada. Electronic address: Eric.Horlick@uhn.ca.
Jazyk: angličtina
Zdroj: Journal of cardiovascular computed tomography [J Cardiovasc Comput Tomogr] 2023 Nov-Dec; Vol. 17 (6), pp. 373-383. Date of Electronic Publication: 2023 Aug 25.
DOI: 10.1016/j.jcct.2023.08.010
Abstrakt: Different methodologies have been used to assess the role of AV calcification (AVC) on TAVI outcomes. This systematic review aims to describe the burden of AVC, synthesize the different methods of calcium score quantification, and evaluate the impact of AVC on outcomes after TAVI. We included studies of TAVI patients who had reported AV calcium scoring by contrast-enhanced multidetector CT and the Agatston method. The impact of calcification on TAVI outcomes without restrictions on follow-up time or outcome type was evaluated. Results were reported descriptively, and a meta-analysis was conducted when feasible. Sixty-eight articles were included, with sample sizes ranging from 23 to 1425 patients. Contrast-enhanced calcium scoring was reported in 30 studies, calcium volume score in 28 studies, and unique scoring methods in two. All studies with calcium volume scores had variable protocols, but most utilized a modified Agatston method with variable attenuation threshold values of 300-850 HU. Eight studies used the Agatston method, with the overall mean AV calcium score in studies published from 2010 to 2012 of 3342.9 AU [95%CI: 3150.4; 3535.4, I2 ​= ​0%]. The overall mean score was lower and heterogenous in studies published from 2014 to 2020 (2658.9 AU [95% CI: 2517.3; 2800.5, I2 ​= ​79%]. Most studies reported a positive association between calcium burden and increased risk of adverse outcomes, including implantation of permanent pacemaker (7/8 studies), paravalvular leak (13/13 studies), and risk of aortic rupture (2/2 studies). AVC quantification methodology with contrast-enhanced CT is still variable. AVC negatively impacts TAVI outcomes independently of the quantification method.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
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