In this retrospective study, researchers evaluated whether perivascular adipose tissue (PVAT) attenuation around the aortic valve, measured by CT angiography before transcatheter aortic valve replacement (TAVR), predicts post-procedural outcomes in patients with severe aortic stenosis. The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of all-cause mortality, stroke, and heart failure–rehospitalization, with a median follow-up of 2.2 years.
Among 233 patients, MACE occurred in 23.6%. The MACE group exhibited higher PVAT attenuation around the aortic valve (mean −74.0 ± 9.8 HU) compared with the non-MACE group (mean −78.9 ± 9.2 HU; P = 0.001).
In Cox regression analysis, greater PVAT attenuation was independently associated with MACE (hazard ratio 1.52; 95% CI 1.13–2.04; P = 0.006). Adding PVAT attenuation to established prognostic factors improved predictive performance and reclassification for MACE after TAVR.
Conclusion: Elevated PVAT attenuation around the aortic valve is associated with higher risk of MACE following TAVR. Measuring PVAT attenuation pre-TAVR may help identify patients at greater risk for heart failure or cardiovascular death after the procedure.