TY  - JOUR
A1  - Dietl, Alexander
A1  - Prieschenk, Christine
A1  - Eckert, Franziska
A1  - Birner, Christoph
A1  - Luchner, Andreas
A1  - Maier, Lars S.
A1  - Buchner, Stefan
T1  - 3D vena contracta area after MitraClip© procedure: precise quantification of residual mitral regurgitation and identification of prognostic information
JF  - Cardiovascular Ultrasound
N2  - Background
Percutaneous mitral valve repair (PMVR) is increasingly performed in patients with severe mitral regurgitation (MR). Post-procedural MR grading is challenging and an unsettled issue. We hypothesised that the direct planimetry of vena contracta area (VCA) by 3D–transoesophageal echocardiography allows quantifying post-procedural MR and implies further prognostic relevance missed by the usual ordinal scale (grade I-IV).

Methods
Based on a single-centre PMVR registry containing 102 patients, the association of VCA reduction and patients’ functional capacity measured as six-minute walk distance (6 MW) was evaluated. 3D–colour-Doppler datasets were available before, during and 4 weeks after PMVR.

Results
Twenty nine patients (age 77.0 ± 5.8 years) with advanced heart failure (75.9% NYHA III/IV) and severe degenerative (34%) or functional (66%) MR were eligible. VCA was reduced in all patients by PMVR (0.99 ± 0.46 cm\(^2\) vs. 0.22 ± 0.15 cm\(^2\), p < 0.0001). It remained stable after median time of 33 days (p = 0.999). 6 MW improved after the procedure (257.5 ± 82.5 m vs. 295.7 ± 96.3 m, p < 0.01). Patients with a decrease in VCA less than the median VCA reduction showed a more distinct improvement in 6 MW than patients with better technical result (p < 0.05). This paradoxical finding was driven by inferior results in very large functional MR.

Conclusions
VCA improves the evaluation of small residual MR. Its post-procedural values remain stable during a short-term follow-up and imply prognostic information for the patients’ physical improvement. VCA might contribute to a more substantiated estimation of treatment success in the heterogeneous functional MR group.
KW  - percutaneous mitral valve repair
KW  - MitraClip
KW  - 3D echocardiography
KW  - vena contracta area
KW  - six-minute walk test
KW  - NT-proBNP
KW  - prognosis
KW  - functional mitral regurgitation
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-225318
VL  - 16
ER  - 
TY  - JOUR
A1  - Woźnicki, Piotr
A1  - Laqua, Fabian Christopher
A1  - Messmer, Katharina
A1  - Kunz, Wolfgang Gerhard
A1  - Stief, Christian
A1  - Nörenberg, Dominik
A1  - Schreier, Andrea
A1  - Wójcik, Jan
A1  - Ruebenthaler, Johannes
A1  - Ingrisch, Michael
A1  - Ricke, Jens
A1  - Buchner, Alexander
A1  - Schulz, Gerald Bastian
A1  - Gresser, Eva
T1  - Radiomics for the prediction of overall survival in patients with bladder cancer prior to radical cystectomy
JF  - Cancers
N2  - (1) Background: To evaluate radiomics features as well as a combined model with clinical parameters for predicting overall survival in patients with bladder cancer (BCa). (2) Methods: This retrospective study included 301 BCa patients who received radical cystectomy (RC) and pelvic lymphadenectomy. Radiomics features were extracted from the regions of the primary tumor and pelvic lymph nodes as well as the peritumoral regions in preoperative CT scans. Cross-validation was performed in the training cohort, and a Cox regression model with an elastic net penalty was trained using radiomics features and clinical parameters. The models were evaluated with the time-dependent area under the ROC curve (AUC), Brier score and calibration curves. (3) Results: The median follow-up time was 56 months (95% CI: 48–74 months). In the follow-up period from 1 to 7 years after RC, radiomics models achieved comparable predictive performance to validated clinical parameters with an integrated AUC of 0.771 (95% CI: 0.657–0.869) compared to an integrated AUC of 0.761 (95% CI: 0.617–0.874) for the prediction of overall survival (p = 0.98). A combined clinical and radiomics model stratified patients into high-risk and low-risk groups with significantly different overall survival (p < 0.001). (4) Conclusions: Radiomics features based on preoperative CT scans have prognostic value in predicting overall survival before RC. Therefore, radiomics may guide early clinical decision-making.
KW  - bladder cancer
KW  - radical cystectomy
KW  - radiomics
KW  - outcome prediction
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-288098
SN  - 2072-6694
VL  - 14
IS  - 18
ER  -