{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:17:53Z","timestamp":1793722673796,"version":"4.6.1"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022720","name":"Fondazione Regionale per la Ricerca Biomedica","doi-asserted-by":"publisher","award":["3432721"],"award-info":[{"award-number":["3432721"]}],"id":[{"id":"10.13039\/501100022720","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Computed tomography (CT)-derived extracellular volume (ECV) fraction is a non-invasive method to quantify myocardial fibrosis. Evaluating CT-ECV during aortic valve replacement (AVR) planning CT in severe aortic stenosis (AS) may aid prognostic stratification. This meta-analysis evaluated the prognostic significance of CT-ECV in severe AS necessitating AVR. Electronic database searches of PubMed, Ovid MEDLINE, and Cochrane Library were performed. The primary outcome was to compare the occurrence of a composite of cardiovascular outcomes in patients with severe AS undergoing AVR with elevated myocardial CT-ECV values vs. patients with normal values. Secondary outcomes included all-cause mortality and heart failure (HF)-related hospitalization. A total of 1223 patients undergoing AVR for severe AS were included in 10 studies: 524 patients with high values of CT-ECV and 699 with normal values of CT-ECV. The pooled CT-ECV cut-off to define elevated values and predict prognosis was 30.7% [95% confidence interval (CI): 28.5\u201333.7%]. At a mean follow-up of 17.9 \u00b1 2.3 months after AVR, patients with elevated CT-ECV experienced a significantly higher number of cardiovascular events [43.4 vs. 14.0%; odds ratio (OR): 4.3, 95% CI: 3.192\u20135.764, P &amp;lt; 0.001]. Regarding secondary outcomes, all-cause mortality occurred in 29.3% of patients with elevated CT-ECV vs. 11.6% with CT-ECV below the cut-off (OR: 3.5, 95% CI: 2.276\u20135.311, P &amp;lt; 0.001), whereas HF hospitalization was observed in 25.5% vs. 5.9% (OR: 4.9, 95% CI: 2.283\u201310.376, P &amp;lt; 0.001). Patients undergoing AVR for severe AS with elevated CT-ECV values experience a worse post-intervention prognosis. The implementation of CT-ECV evaluation in routine AVR planning protocols should be considered.<\/jats:p>","DOI":"10.1093\/ehjci\/jeae324","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T07:30:05Z","timestamp":1734507005000},"page":"518-531","source":"Crossref","is-referenced-by-count":13,"title":["Prognostic value of myocardial computed tomography\u2013derived extracellular volume in severe aortic stenosis requiring aortic valve replacement: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-3203","authenticated-orcid":false,"given":"Andrea","family":"Faggiano","sequence":"first","affiliation":[{"name":"Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , 20122 Milan ,","place":["Italy"]},{"name":"Department of Clinical Sciences and Community Health, University of Milan , 20122 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Gherbesi","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , 20122 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Carugo","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , 20122 Milan ,","place":["Italy"]},{"name":"Department of Clinical Sciences and Community Health, University of Milan , 20122 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2077-2879","authenticated-orcid":false,"given":"Matteo","family":"Brusamolino","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan , 20122 Milan ,","place":["Italy"]},{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS , Via C. Parea 4, 20138 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Alexandru","family":"Cozac","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova , Padova ,","place":["Italy"]},{"name":"Department of Physiology, University of Medicine, Pharmacy, Science and Technology \u2018George Emil Palade\u2019 of T\u00e2rgu Mure\u0219 , 540142 T\u00e2rgu Mure\u0219 ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cozza","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova , Padova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Savo","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova , Padova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cannata","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS , Via C. Parea 4, 20138 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Guglielmo","sequence":"additional","affiliation":[{"name":"Division of Heart and Lungs, Department of Cardiology, Utrecht University Medical Center, Utrecht University , Utrecht ,","place":["The Netherlands"]},{"name":"Department of Cardiology, Haga Teaching Hospital , The Hague ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"La Mura","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, University Federico II of Naples , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Fazzari","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS , Via C. Parea 4, 20138 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5190-5227","authenticated-orcid":false,"given":"Nazario","family":"Carrabba","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracovascular Medicine, Azienda Ospedaliero-Universitaria Careggi , Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1443-5788","authenticated-orcid":false,"given":"Edoardo","family":"Conte","sequence":"additional","affiliation":[{"name":"Department of Clinical Cardiology and Cardiovascular Imaging, Galeazzi-Sant\u2019Ambrogio Hospital IRCCS , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saima","family":"Mushtaq","sequence":"additional","affiliation":[{"name":"Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS , Via C. 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