{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:59:51Z","timestamp":1787065191633,"version":"build-2736575974"},"reference-count":32,"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":[[2024,9,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Paravalvular regurgitation (PVR) is a common complication after transcatheter aortic valve replacement, posing an increased risk of heart failure and mortality. Accurate intraprocedural quantification of PVR is challenging. Both hemodynamic indices and videodensitometry can be used for intraprocedural assessment of PVR. We compared the predictive value of the isolated versus combined use of the hemodynamic index diastolic delta (DD) and videodensitometry for the incidence of relevant PVR 1\u2009month after transcatheter aortic valve replacement.<\/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                      In this prospective cohort study, patients underwent periprocedural PVR assessment by DD and videodensitometry (using left ventricular outflow tract\u2014aortic regurgitation [LVOT\u2010AR]). Cardiac magnetic resonance served as reference modality for PVR assessment. Relevant PVR was defined as cardiac magnetic resonance\u2013regurgitant fraction &gt;20%. Fifty\u2010one patients were enrolled in this study. Mean age was 80.6\u00b15.2\u2009years and 45.1% of patients were men. Mean LVOT\u2010AR and cardiac magnetic resonance\u2013regurgitant fraction were 8.2%\u00b17.8% and 11.7%\u00b19.6%, respectively. The correlation between DD and LVOT\u2010AR was weak (\n                      <jats:italic>r<\/jats:italic>\n                      =\u22120.36). DD and LVOT\u2010AR showed a comparable accuracy to predict relevant PVR (area under the curve 0.82, 95% CI: 0.69\u20130.95 versus area area under the time\u2013density curve 0.80, 95% CI: 0.62\u20130.99). The combination of DD and LVOT\u2010AR improved the prediction of relevant PVR (area under the time\u2013density curve, 0.90, 95% CI: 0.81\u20130.99), and resulted in an increased concordance (86.3%) and positive predictive value (75%) compared with DD alone (76.5% and 40%, respectively), or LVOT\u2010AR alone (82.3% and 50%, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">DD and videodensitometry are both accurate and feasible modalities for the assessment of PVR after transcatheter aortic valve replacement. The synergistic use of both techniques increases the predictive value for relevant PVR after transcatheter aortic valve replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT04281771.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.035587","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T05:19:22Z","timestamp":1726204762000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Periprocedural Assessment of Paravalvular Regurgitation After Transcatheter Aortic Valve Replacement Using Diastolic Delta and Videodensitometry"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6815-7667","authenticated-orcid":false,"given":"Maxim J. P.","family":"Rooijakkers","sequence":"first","affiliation":[{"name":"Department of Cardiology Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6325-1056","authenticated-orcid":false,"given":"Ahmed","family":"Elkoumy","sequence":"additional","affiliation":[{"name":"CORRIB Research Centre for Advanced Imaging and Core Laboratory University of Galway Galway Ireland"},{"name":"Islamic Center of Cardiology and Cardiac Surgery Al\u2010Azhar University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7487-151X","authenticated-orcid":false,"given":"Niels A.","family":"Stens","sequence":"additional","affiliation":[{"name":"Department of Cardiology Radboud University Medical Center Nijmegen The Netherlands"},{"name":"Department of Medical BioSciences Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4579-111X","authenticated-orcid":false,"given":"Marleen H.","family":"van Wely","sequence":"additional","affiliation":[{"name":"Department of Cardiology Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1583-2953","authenticated-orcid":false,"given":"Geert A. A.","family":"Versteeg","sequence":"additional","affiliation":[{"name":"Department of Cardiology Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0426-9360","authenticated-orcid":false,"given":"Tsung\u2010Ying","family":"Tsai","sequence":"additional","affiliation":[{"name":"CORRIB Research Centre for Advanced Imaging and Core Laboratory University of Galway Galway Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Rodwell","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, section Biostatistics Radboud Institute for Health Sciences Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1503-2374","authenticated-orcid":false,"given":"Robin H.","family":"Heijmen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery 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