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This study was designed to assess the prognostic value of the V\/M ratio for predicting major adverse cardiovascular events (MACE) in patients undergoing transcatheter aortic valve replacement (TAVR).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This study enrolled patients who received a standard planning computed tomography (CT) scan before TAVR and dichotomized at the median of 33.31\u00a0mm\u00b3\/g of V\/M ratio into groups with low V\/M ratio and high V\/M ratio. The V\/M ratio was calculated by coronary computed tomography angiography (CTA). The endpoint was a composite of all-cause mortality, stroke, and hospitalization for heart failure. The cumulative incidence of the MACE was compared using Kaplan-Meyer plots and uni- and multivariate Cox proportional hazards regression analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In total, 139 patients were enrolled in this study finally (mean age 71.7\u2009\u00b1\u20096.7 years, 41.7% female). The mean V\/M ratio was considerably lower in patients with MACE than in those without MACE (26.5\u2009\u00b1\u20094.9mm<jats:sup>3<\/jats:sup>\/g vs. 34.0\u2009\u00b1\u20093.8mm<jats:sup>3<\/jats:sup>\/g, <jats:italic>P<\/jats:italic>&lt;0.001). Multivariate Cox proportional hazards regression showed that the low V\/M ratio group (\u2264\u200933.31\u00a0mm\u00b3\/g) had a higher risk of MACE after TAVR (HR: 6.14, 95%CI: 1.37\u201327.54; <jats:italic>P<\/jats:italic>\u2009=\u20090.018).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The lower V\/M ratio could serve as an independent predictor of MACE in patients undergoing TAVR.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical trial number<\/jats:title>\n            <jats:p>Not applicable.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12872-025-04705-9","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:57:10Z","timestamp":1745456230000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Computed tomography-based coronary lumen volume to myocardial mass ratio in patients undergoing transcatheter aortic valve replacement: a novel method for risk assessment"],"prefix":"10.1186","volume":"25","author":[{"given":"Wenting","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruichen","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyuan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"4705_CR1","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","volume":"368","author":"VT Nkomo","year":"2006","unstructured":"Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. 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