Computed Tomographic Evidence of Fluid Overload as an Indicator of Decreased Survival in Patients Undergoing Evaluation for Transcatheter Aortic Valve Replacement.

Abstract

PURPOSE: To characterize the predictive value of CT findings of fluid overload for predicting survival in patients undergoing transcatheter aortic valve replacement (TAVR).MATERIALS AND METHODS: A retrospective review was performed on 265 patients undergoing CTA for TAVR planning purposes. Images for each patient were analyzed for evidence of fluid overload. Additional clinical data were gathered for each patient including serum NT-proBNP, eGFR, and albumin along with echocardiographic evaluation of left ventricular systolic function. Survival between groups with and without CT evidence of fluid overload (CTFO) was compared using Kaplan-Meier survival analysis and Cox proportional hazards model.RESULTS: Kaplan-Meier analysis demonstrates survival differences between the subjects with and without evidence of fluid overload. The Cox model demonstrates that CTFO is an independent predictor of survival outcomes. The hazard ratio in a model accounting for multiple variables was 2.93 with a P-value of 0.01. Notably, the Kaplan-Meier analysis demonstrates 100% survival for the first 50 days in patients with euvolemia on CT.CONCLUSIONS: CT evidence of fluid overload before TAVR is associated with increased mortality.

View details for DOI 10.1097/RCT.0000000000001816

View details for PubMedID 41085279