Your CT scans are hiding crucial TAVI survival data: Are you looking?
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216224%3A14110%2F25%3A00143020" target="_blank" >RIV/00216224:14110/25:00143020 - isvavai.cz</a>
Result on the web
<a href="https://www.sciencedirect.com/science/article/pii/S2666602225001521?pes=vor&utm_source=clarivate&getft_integrator=clarivate" target="_blank" >https://www.sciencedirect.com/science/article/pii/S2666602225001521?pes=vor&utm_source=clarivate&getft_integrator=clarivate</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.ahjo.2025.100649" target="_blank" >10.1016/j.ahjo.2025.100649</a>
Alternative languages
Result language
angličtina
Original language name
Your CT scans are hiding crucial TAVI survival data: Are you looking?
Original language description
Transcatheter Aortic Valve Implantation (TAVI) has revolutionized treatment for severe aortic stenosis, but optimal patient selection remains challenging. This commentary highlights findings from our recent systematic review of 14 studies comprising 9692 TAVI patients, which revealed that CT-derived adipose tissue parameters provide valuable prognostic information often overlooked during procedural planning. We found that higher subcutaneous adipose tissue consistently associated with better survival, while adipose tissue quality, measured by CT attenuation, proved equally important. The relationship between adiposity and outcomes appears Ushaped rather than linear, with both extremely low and high adiposity quartiles correlating with worse outcomes, while moderate subcutaneous adiposity provides optimal outcomes by offering metabolic reserves without pathological complications. Notably, fat distribution patterns (VAT:SAT ratio < 1) were associated with better cardiovascular outcomes, underscoring that where fat is stored matters more than total quantity. The obesitydependent effects of visceral adipose tissue reflect fundamental differences in metabolic physiology: in nonobese patients, modest VAT represents protective energy reserves, while in obese patients, lower VAT indicates relatively better metabolic health within the context of existing obesity. These adipose tissue characteristics are readily available in pre-procedural CT scans already used for anatomical assessment, requiring minimal additional resources while potentially enhancing risk stratification. We present a novel decision algorithm with sex-specific thresholds that enables immediate clinical implementation of these measurements for patient risk stratification. As TAVI indications expand to include both increasingly frail elderly patients and those at intermediate surgical risk, integrating these overlooked adipose tissue parameters into clinical decisionmaking could improve patient selection and outcomes.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
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Continuities
S - Specificky vyzkum na vysokych skolach
Others
Publication year
2025
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
American Heart Journal Plus: Cardiology Research and Practice
ISSN
2666-6022
e-ISSN
2666-6022
Volume of the periodical
60
Issue of the periodical within the volume
December 2025
Country of publishing house
NL - THE KINGDOM OF THE NETHERLANDS
Number of pages
5
Pages from-to
1-5
UT code for WoS article
001606485800002
EID of the result in the Scopus database
2-s2.0-105019105877