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骨矿物质密度和TAVR结果:对增强型和非增强型TAVRCT扫描患者进行比较分析

Caglayan Demirel¹, Kevin Hamzaraj¹, Anna Seeber¹

¹Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, Vienna, Austria.

Heart & lung : the journal of critical care

|November 14, 2024

概括

在非增强型CT扫描上测量的低骨矿物质密度 (BMD) 预测过导管大动脉置换 (TAVR) 后的生存率不佳. 与对比度增强的扫描没有显示这种关联,突出显示了TAVR患者评估中非增强的BMD的价值.

科学领域:

心脏病学心脏病学
放射学放射学是一门学科.
老年病的医生老年病的医生

背景情况:

通过导管的大动脉置换 (TAVR) 的程序前评估至关重要,包括脆弱性评估.
计算机断层扫描 (CT) 扫描对于TAVR患者的身体组成分析是强制性的.
低骨矿物质密度 (BMD) 对TAVR结果的预后价值,特别是非增强型CT与对比增强型CT的预后价值,尚未得到充分确立.

研究的目的:

为了研究低骨质量对接受TAVR的患者的生存率的影响.
为了确定使用非增强和增强对比度的TAVRCT扫描来测量BMD的可行性.

主要方法:

分析了725名TAVR患者的队列,其中包括非增强型和对比增强型CT扫描 (2015年11月至2022年3月).
骨矿物质密度 (BMD) 在两个扫描类型上使用Hounsfield单位 (HU) 量化胸椎水平;低BMD被定义为<200 HU.
考克斯回归分析用于调整与骨质疏松症相关的混因素.

主要成果:

在非增强型CT扫描中较低的BMD与TAVR后的生存率降低显著相关 (p=0.046),即使在对骨质疏松症预测因素进行调整后也是如此.
相比之下,在使用对比度增强的CT扫描 (p=0.830) 进行评估时,没有发现低BMD和存活率之间的显著关联.

结论:

在非增强型TAVR-CT扫描上进行机会性骨损伤评估是可行的,并预测TAVR后的不良结果.
将非增强型骨质量测量整合到程序前TAVR评估中可以增强脆弱性评估.
低BMD和TAVR结局之间的关联与非增强型CT成像特异.

关键词:

骨矿物质密度骨矿物质密度用对比度增强的CT扫描扫描.脆弱性评估脆弱性评估非增强型CT扫描扫描.TAVRCT扫描扫描扫描扫描扫描扫描.

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