Title: P5098Percutaneous repair of functional mitral regurgitation in heart failure patients: a meta-analysis of 23 studies on mitraclip implantation
Abstract: Novel determinants of aortic valve calcification / Structural cardiac interventions 1059purpose of this study was to compare the prognostic value of both parameters in patients with symptomatic severe aortic stenosis.Methods: Single-center retrospective study including all patients with symptomatic severe aortic stenosis who underwent cardiac CT to assess eligibility for transcatheter aortic valve implantation (TAVI).The primary endpoint was allcause mortality.Independent prognostic value of aortic valve calcium score and calcium density was analyzed through Cox regression.Results: 245 patients were included (139 women, mean age 82±8 years).The mean valvular area and transvalvular gradient were 0.42±0.12cm 2 /m 2 and 50±15 mmHg, respectively.The median calcium score was 2360 AU (IQR 1698-3480) and the median calcium density was 580 AU/cm 2 (IQR 413-806).The majority of patients underwent TAVI (n=133, 55%) or surgical aortic valve replacement (n=31, 13%), while 75 patients (30%) where refused for or await intervention.The remaining underwent palliative balloon valvuloplasty (n=6, 2%).During a median follow-up of 324 days (IQR 37-611) there were 47 deaths (24 under medical therapy and 23 after intervention).Classification of patients according to calcium score allowed better separation of survival curves when compared to calcium density (picture 1).After adjusting for Euroscore II and valvular intervention, calcium score independently predicted time to death (adjusted HR 1.16 for every 1000AU; 95% CI 1.03-1.32;p=0.017), whereas calcium density was not independently associated with prognostic (adjusted HR 1.02 for every 100 AU/cm 2 ; 95% CI 0.97-1.08;p=0.396).Picture 1 Conclusion:In patients with symptomatic severe aortic stenosis, aortic valve calcium score measured by CT independently predicted all-cause mortality.Indexing this value to LVOT does not seem to bring any additional advantage.