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Article Abstract

Background: The coronary lumen volume to myocardial mass (V/M) ratio has been suggested as a quantitative metric of potential imbalance between coronary blood supply and myocardial oxygen demand. 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).

Methods: This study enrolled patients who received a standard planning computed tomography (CT) scan before TAVR and dichotomized at the median of 33.31 mm³/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.

Results: In total, 139 patients were enrolled in this study finally (mean age 71.7 ± 6.7 years, 41.7% female). The mean V/M ratio was considerably lower in patients with MACE than in those without MACE (26.5 ± 4.9mm/g vs. 34.0 ± 3.8mm/g, P<0.001). Multivariate Cox proportional hazards regression showed that the low V/M ratio group (≤ 33.31 mm³/g) had a higher risk of MACE after TAVR (HR: 6.14, 95%CI: 1.37-27.54; P = 0.018).

Conclusions: The lower V/M ratio could serve as an independent predictor of MACE in patients undergoing TAVR.

Clinical Trial Number: Not applicable.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020294PMC
http://dx.doi.org/10.1186/s12872-025-04705-9DOI Listing

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