{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:08:19Z","timestamp":1790845699805,"version":"4.1.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To determine the conditions under which early hypoattenuated leaflet thickening (HALT) after transcatheter aortic valve implantation (TAVI) becomes haemodynamically relevant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The study included 100 patients (age: 81.5 \u00b1 5.5 years; female 63%), thereof 50 patients with HALT. After anonymization and randomization, blinded readers measured maximum thrombus thickness per prosthesis (MT_pr) and movement restriction (MR_pr) on electrocardiogram (ECG)-gated whole heart cycle computed tomography angiography. These measurements were compared with echocardiographic mean pressure gradient (mPG), its increase from baseline (\u0394mPG), and Doppler velocity index (DVI). Haemodynamic valve deterioration (HVD) was defined as mPG &amp;gt; 20 mmHg. Age, body mass index, valve type, valve size, left ventricular ejection fraction, and atrial fibrillation were considered as influencing factors. Multiple regression analysis revealed that only valve size (P = 0.001) and MT_pr (P = 0.02) had a significant influence on mPG. In an interaction model, valve size moderated the effect of MT_pr on mPG significantly (P = 0.004). Sub-group analysis stratified by valve sizes showed a strong correlation between MT_pr and echocardiographic parameters for 23 mm valves (mPG: r = 0.57, \u0394mPG: r = 0.68, DVI: r = 0.55, each with P &amp;lt; 0.001), but neither for 26 nor 29 mm valves (r &amp;lt; 0.2, P &amp;gt; 0.2 for all correlations). Six of seven prostheses with HVD had a 23 mm valve diameter, while one had 29 mm (P = 0.02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Early HALT rarely causes significant mPG increase. Our study shows that valve size is a key factor influencing the haemodynamic impact of HALT. In small valve sizes, mPG is more likely to increase. Our study is the first to offer in vivo evidence supporting previous in vitro findings on this topic.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jead156","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T10:30:58Z","timestamp":1688639458000},"page":"1672-1681","source":"Crossref","is-referenced-by-count":5,"title":["Investigation of factors determining haemodynamic relevance of leaflet thrombosis after transcatheter aortic valve implantation"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6314-1829","authenticated-orcid":false,"given":"Martin","family":"Soschynski","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg , Hugstetter Stra\u00dfe 55, 79106 Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0430-7184","authenticated-orcid":false,"given":"Manuel","family":"Hein","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg , Hugstetter Stra\u00dfe 55, 79106 Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6459-6275","authenticated-orcid":false,"given":"Fabio","family":"Capilli","sequence":"additional","affiliation":[{"name":"Department of Radiology, Neuroradiology and Nuclear Medicine, Medical Center Vest, Ruhr University Bochum , Dorstener Stra\u00dfe 151, 45657 Recklinghausen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9826-2372","authenticated-orcid":false,"given":"Muhammad Taha","family":"Hagar","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg , Hugstetter Stra\u00dfe 55, 79106 Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3379-5797","authenticated-orcid":false,"given":"Philipp","family":"Ruile","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg , Hugstetter Stra\u00dfe 55, 79106 Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7390-5287","authenticated-orcid":false,"given":"Philipp","family":"Breitbart","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg , Hugstetter Stra\u00dfe 55, 79106 Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7542-1956","authenticated-orcid":false,"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg , Hugstetter Stra\u00dfe 55, 79106 Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Taron","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg , Hugstetter Stra\u00dfe 55, 79106 Freiburg , Germany"},{"name":"Cardiac MR PET CT Program, Massachusetts General-Hospital\u2014Harvard Medical School , 55 Fruit Street, Boston, MA 02114 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9675-803X","authenticated-orcid":false,"given":"Christopher","family":"Schuppert","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg , Hugstetter Stra\u00dfe 55, 79106 Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-1481","authenticated-orcid":false,"given":"Christopher L","family":"Schlett","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg , Hugstetter Stra\u00dfe 55, 79106 Freiburg , 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