Detail
Článek
Článek online
FT
Medvik - BMČ
  • Je něco špatně v tomto záznamu ?

Multiparametric Strategy to Predict Early Disease Decompensation in Asymptomatic Severe Aortic Regurgitation

R. Kočková, H. Línková, Z. Hlubocká, K. Mědílek, M. Tuna, J. Vojáček, I. Skalský, Š. Černý, J. Malý, J. Hlubocký, T. Mizukami, C. De Colle, M. Pěnička

. 2022 ; 15 (12) : e014901. [pub] 20221220

Jazyk angličtina Země Spojené státy americké

Typ dokumentu multicentrická studie, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22032273

BACKGROUND: Use of the current echocardiography-based indications for aortic regurgitation (AR) surgery might result in late valve replacement at the stage of irreversible myocardial damage. Therefore, we aimed to identify simple models combining multiple echocardiography or magnetic resonance imaging (MRI)-derived indices and natriuretic peptides (BNP [brain natriuretic peptide] or NT-proBNP [N-terminnal pro-B type natriuretic peptide]) to predict early disease decompensation in asymptomatic severe AR. METHODS: This prospective and multicenter study included asymptomatic patients with severe AR, preserved left ventricular ejection fraction (>50%), and sinus rhythm. The echocardiography and MRI images were analyzed centrally in the CoreLab. The study end point was the onset of indication for aortic valve surgery as per current guidelines. RESULTS: The derivative cohort consisted of 127 asymptomatic patients (age 45±14 years, 84% males) with 41 (32%) end points during a median follow-up of 1375 (interquartile range, 1041-1783) days. In multivariable Cox regression analysis, age, BNP, 3-dimensional vena contracta area, MRI left ventricular end-diastolic volume index, regurgitant volume, and a fraction were identified as independent predictors of end point (all P<0.05). However, a combined model including one parameter of AR assessment (MRI regurgitant volume or regurgitant fraction or 3-dimensional vena contracta area), 1 parameter of left ventricular remodeling (MRI left ventricular end-diastolic volume index or echocardiography 2-dimensional global longitudinal strain or E wave), and BNP showed significantly higher predictive accuracy (area under the curve, 0.74-0.81) than any parameter alone (area under the curve, 0.61-0.72). These findings were confirmed in the validation cohort (n=100 patients, 38 end points). CONCLUSIONS: In asymptomatic severe AR, multimodality and multiparametric model combining 2 imaging indices with natriuretic peptides, showed high accuracy to identify early disease decompensation. Further prospective studies are warranted to explore the clinical benefit of implementing these models to guide patient management. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02910349.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc22032273
003      
CZ-PrNML
005      
20230131151644.0
007      
ta
008      
230120s2022 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1161/CIRCIMAGING.122.014901 $2 doi
035    __
$a (PubMed)36538596
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Kočková, Radka $u Cardiothoracic Surgery Department, Na Homolce Hospital, Czech Republic (R.K., I.S., S.C.) $1 https://orcid.org/0000000266450245
245    10
$a Multiparametric Strategy to Predict Early Disease Decompensation in Asymptomatic Severe Aortic Regurgitation / $c R. Kočková, H. Línková, Z. Hlubocká, K. Mědílek, M. Tuna, J. Vojáček, I. Skalský, Š. Černý, J. Malý, J. Hlubocký, T. Mizukami, C. De Colle, M. Pěnička
520    9_
$a BACKGROUND: Use of the current echocardiography-based indications for aortic regurgitation (AR) surgery might result in late valve replacement at the stage of irreversible myocardial damage. Therefore, we aimed to identify simple models combining multiple echocardiography or magnetic resonance imaging (MRI)-derived indices and natriuretic peptides (BNP [brain natriuretic peptide] or NT-proBNP [N-terminnal pro-B type natriuretic peptide]) to predict early disease decompensation in asymptomatic severe AR. METHODS: This prospective and multicenter study included asymptomatic patients with severe AR, preserved left ventricular ejection fraction (>50%), and sinus rhythm. The echocardiography and MRI images were analyzed centrally in the CoreLab. The study end point was the onset of indication for aortic valve surgery as per current guidelines. RESULTS: The derivative cohort consisted of 127 asymptomatic patients (age 45±14 years, 84% males) with 41 (32%) end points during a median follow-up of 1375 (interquartile range, 1041-1783) days. In multivariable Cox regression analysis, age, BNP, 3-dimensional vena contracta area, MRI left ventricular end-diastolic volume index, regurgitant volume, and a fraction were identified as independent predictors of end point (all P<0.05). However, a combined model including one parameter of AR assessment (MRI regurgitant volume or regurgitant fraction or 3-dimensional vena contracta area), 1 parameter of left ventricular remodeling (MRI left ventricular end-diastolic volume index or echocardiography 2-dimensional global longitudinal strain or E wave), and BNP showed significantly higher predictive accuracy (area under the curve, 0.74-0.81) than any parameter alone (area under the curve, 0.61-0.72). These findings were confirmed in the validation cohort (n=100 patients, 38 end points). CONCLUSIONS: In asymptomatic severe AR, multimodality and multiparametric model combining 2 imaging indices with natriuretic peptides, showed high accuracy to identify early disease decompensation. Further prospective studies are warranted to explore the clinical benefit of implementing these models to guide patient management. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02910349.
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé $7 D006801
650    _2
$a dospělí $7 D000328
650    _2
$a lidé středního věku $7 D008875
650    _2
$a ženské pohlaví $7 D005260
650    12
$a aortální insuficience $x diagnostické zobrazování $x etiologie $x chirurgie $7 D001022
650    _2
$a tepový objem $7 D013318
650    _2
$a funkce levé komory srdeční $7 D016277
650    _2
$a echokardiografie $7 D004452
650    _2
$a magnetická rezonanční tomografie $7 D008279
650    _2
$a natriuretický peptid typu B $7 D020097
655    _2
$a multicentrická studie $7 D016448
655    _2
$a časopisecké články $7 D016428
700    1_
$a Línková, Hana $u Department of Cardiology, Royal Vinohrady University Hospital, Czech Republic (H.L.)
700    1_
$a Hlubocká, Zuzana $u Department of Cardiology (Z.H.), General University Hospital, Prague, Czech Republic $1 https://orcid.org/0000000235782140
700    1_
$a Mědílek, Karel $u 1st Department Medicine - Cardioangiology, University Hospital Hradec Králové, Sokolská Czech Republic (K.M.)
700    1_
$a Tuna, Martin $u Department of Cardiac Surgery, University Hospital Hradec Králové, Hradec Králové, Czech Republic (M.T., J.V.) $1 https://orcid.org/0000000203379445
700    1_
$a Vojáček, Jan $u Department of Cardiac Surgery, University Hospital Hradec Králové, Hradec Králové, Czech Republic (M.T., J.V.)
700    1_
$a Skalský, Ivo $u Cardiothoracic Surgery Department, Na Homolce Hospital, Czech Republic (R.K., I.S., S.C.)
700    1_
$a Černý, Štěpán $u Cardiothoracic Surgery Department, Na Homolce Hospital, Czech Republic (R.K., I.S., S.C.)
700    1_
$a Malý, Jiří $u Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.M.)
700    1_
$a Hlubocký, Jaroslav $u Department of Cardiovascular Surgery (J.H.), General University Hospital, Prague, Czech Republic
700    1_
$a Mizukami, Takuya $u Cardiovascular Center Aalst, Belgium (T.M., C.D.C., M.P.) $u Division of Clinical Pharmacology, Department of Pharmacology, Showa University, Tokyo, Japan (T.M.) $1 https://orcid.org/0000000310868746
700    1_
$a De Colle, Cristina $u Cardiovascular Center Aalst, Belgium (T.M., C.D.C., M.P.) $u Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy (C.D.C.)
700    1_
$a Pěnička, Martin $u Cardiovascular Center Aalst, Belgium (T.M., C.D.C., M.P.)
773    0_
$w MED00160628 $t Circulation. Cardiovascular imaging $x 1942-0080 $g Roč. 15, č. 12 (2022), s. e014901
856    41
$u https://pubmed.ncbi.nlm.nih.gov/36538596 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20230120 $b ABA008
991    __
$a 20230131151640 $b ABA008
999    __
$a ok $b bmc $g 1891181 $s 1183608
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2022 $b 15 $c 12 $d e014901 $e 20221220 $i 1942-0080 $m Circulation. Cardiovascular imaging $n Circ Cardiovasc Imaging $x MED00160628
LZP    __
$a Pubmed-20230120

Najít záznam

Citační ukazatele

Možnosti archivace