Your CT scans are hiding crucial TAVI survival data: Are you looking?

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Your CT scans are hiding crucial TAVI survival data: Are you looking?

Popis výsledku v původním jazyce

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 &lt; 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.

Název v anglickém jazyce

Your CT scans are hiding crucial TAVI survival data: Are you looking?

Popis výsledku anglicky

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 &lt; 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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

S - Specificky vyzkum na vysokych skolach

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

American Heart Journal Plus: Cardiology Research and Practice

ISSN

2666-6022

e-ISSN

2666-6022

Svazek periodika

60

Číslo periodika v rámci svazku

December 2025

Stát vydavatele periodika

NL - Nizozemsko

Počet stran výsledku

5

Strana od-do

1-5

Kód UT WoS článku

001606485800002

EID výsledku v databázi Scopus

2-s2.0-105019105877