Value of echocardiography in the diagnosis of leaflet thrombosis after transcatheter aortic valve replacement
Objective To investigate the value of echocardiography in the diagnosis of leaflet thrombosis after transcatheter aortic valve replacement(TAVR).Methods A total of 115 patients who successfully underwent TAVR in Beijing Anzhen Hospital,Capital Medical University from January 1,2023 to July 1,2023 were selected as the research objects.According to the presence or absence of subclinical leaflet thrombosis(SLT)after TAVR,the patients were divided into normal group(85 cases)and thrombosis group(30 cases).According to the degree of SLT,the thrombosis group was divided into mild SLT group(17 cases)and moderate to severe SLT group(13 cases).Left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),aortic valve peak velocity(Vmax),mean pressure gradient(MPG),aortic valve orifice area(AVA),amount of change in Vmax(△Vmax),amount of change in MPG(△MPG),amount of change in AVA(△AVA),rate of change in Vmax(△Vmax％),rate of change in MPG(△MPG％),and rate of change in AVA(△AVA％)were compared between the two groups.Receiver operating characteristic curve was used to analyze the influencing factors of moderate to severe SLT.Results There were no significant differences in LVEDD,LVEF,Vmax,MPG and AVA between the thrombosis group and the normal group(all P＞0.05).The △Vmax,△MPG,△Vmax％and △MPG％in the thrombosis group were higher than those in the normal group,while the △ AV A and △AVA％were lower than those in the normal group(all P＜0.05).There were no significant differences in LVEDD,LVEF,Vmax,MPG and AVA among the moderate to severe SLT group,mild SLT group and normal group(all P＞0.05).There were significant differences in △Vmax,△MPG,△AVA,△Vmax％and △MPG％among the moderate to severe SLT group,mild SLT group and normal group(all P＜0.05).The △Vmax,△MPG,△Vmax％and △MPG％in the moderate to severe SLT group were higher than those in the mild SLT group and the normal group,△AVA and△AVA％were lower than those in the normal group,and △AVA was lower than that in the mild SLT group(all P＜0.05).The results of receiver operating characteristic curve analysis showed that the areas under the curve of△Vmax＞77 cm/s,△MPG＞6 mmHg,△AVA≤-0.01 cm2,△Vmax％＞35％,and △MPG％＞143％for predicting moderate to severe SLT after TAVR were 0.754,0.733,0.726,0.784 and 0.788,respectively,and the specificity were 80.4％,73.5％,65.7％,70.6％and 90.2％,and the sensitivity were 61.5％,61.5％,76.9％,76.9％and 61.5％,respectively(all P＜0.05).Conclusion Echocardiography has a certain diagnostic value for the formation of moderate to severe SLT after TAVR.△Vmax,△MPG,△AVA,△Vmax％and △MPG％can provide a reference for the identification of moderate to severe SLT after TAVR with certain accuracy.
万方数据
维普
