{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:34:08Z","timestamp":1792416848054,"version":"4.4.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,9,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Myocardial extracellular volume fraction (ECV), measured by cardiac magnetic resonance imaging, is a useful prognostic marker for patients who have undergone aortic valve replacement (AVR) for aortic stenosis. However, the prognostic significance of ECV measurements based on computed tomography (CT) is unclear. This study evaluated the association between ECV measured with dual\u2010energy CT and clinical outcomes in patients with aortic stenosis who underwent transcatheter or surgical AVR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We retrospectively enrolled 95 consecutive patients (age, 84.0\u00b15.0\u00a0years; 75% women) with severe aortic stenosis who underwent preprocedural CT for transcatheter AVR planning. ECV was measured using iodine density images obtained by delayed enhancement dual\u2010energy CT. The primary end point was a composite outcome of all\u2010cause death and hospitalization for heart failure after AVR. The mean ECV measured with CT was 28.1\u00b13.8%. During a median follow\u2010up of 2.6\u00a0years, 22 composite outcomes were observed, including 15 all\u2010cause deaths and 11 hospitalizations for heart failure. In Kaplan\u2010Meier analysis, the high ECV group (\u226527.8% [median value]) had significantly higher rates of composite outcomes than the low ECV group (&lt;27.8%) (log\u2010rank test,\n              <jats:italic>P<\/jats:italic>\n              =0.012). ECV was the only independent predictor of adverse outcomes on multivariable Cox regression analysis (hazards ratio, 1.25; 95% CI, 1.10\u20121.41;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Myocardial ECV measured with dual\u2010energy CT in patients who underwent aortic valve intervention was an independent predictor of adverse outcomes after AVR.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020655","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T08:59:21Z","timestamp":1630918761000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual\u2010Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis"],"prefix":"10.1161","volume":"10","author":[{"given":"Masataka","family":"Suzuki","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0205-928X","authenticated-orcid":false,"given":"Takayoshi","family":"Toba","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Izawa","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Internal Medicine Kobe University Graduate School of Medicine 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