<div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="206825678" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{10}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">Periaortic adipose tissue (PAAT) attenuation</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">may</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>be used as a</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>modifiable imaging marker<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">for</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">post-</span><span class="NormalTextRun SCXW6243700 BCX0">transcatheter aortic valve replacement (TAVR)</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">risk</span><span class="NormalTextRun SCXW6243700 BCX0">, researchers on a retrospective<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW6243700 BCX0">multicent</span><span class="NormalTextRun SpellingErrorV2Themed SCXW6243700 BCX0">er</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>cohort study concluded.</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="800733346" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{12}"><span class="NormalTextRun SCXW6243700 BCX0">The findings were published in a research letter online ahead of print in<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">JACC: Cardiovascular Imaging</span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">,<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">by researchers from<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">Massachusetts</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">General</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">Hospital</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>and</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">Harvard</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">Medical School</span><span class="NormalTextRun SCXW6243700 BCX0">,</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>Boston,<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">led by Jan M Brendel, MD.<span> </span></span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="1148918130" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{14}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">“</span><span class="NormalTextRun SCXW6243700 BCX0">Mortality after transcatheter aortic valve replacement (TAVR) remains<span> </span></span></span><a class="Hyperlink SCXW6243700 BCX0" href="https://pubmed.ncbi.nlm.nih.gov/33332149/" target="_blank" rel="noreferrer noopener"><span class="NormalTextRun SCXW6243700 BCX0" data-ccp-charstyle="Hyperlink">high</span></a><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">, and with its expanding use in lower-risk patients, novel markers of long-term risk are needed to improve patient management</span><span class="NormalTextRun SCXW6243700 BCX0">,” the</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>investigators<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">stressed.<span> </span></span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="593220512" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{16}"><span class="NormalTextRun SCXW6243700 BCX0">PAAT<span> </span></span><a class="Hyperlink SCXW6243700 BCX0" href="https://pubmed.ncbi.nlm.nih.gov/40365683/" target="_blank" rel="noreferrer noopener"><span class="NormalTextRun SCXW6243700 BCX0" data-ccp-charstyle="Hyperlink">marks</span></a><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>peri-aortic inflammation, th</span><span class="NormalTextRun SCXW6243700 BCX0">ey added,<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">noting</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>it<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">can</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>be<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">“</span><span class="NormalTextRun SCXW6243700 BCX0">opportunistically quantified on preprocedural computed tomography (CT) for TAVR planning</span><span class="NormalTextRun SCXW6243700 BCX0">”.</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">Still, its prognostic relevance in TAVR mortality has<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">remained</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>unclear. </span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="1939563189" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{18}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">The current study<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">examined</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>whether higher PAAT attenuation found on routine pre-procedural CT examinations was associated with increased long-term</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>(median 22</span><span class="NormalTextRun SCXW6243700 BCX0">-</span><span class="NormalTextRun SCXW6243700 BCX0">month follow-up)</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>all-cause post-TAVR mortality</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>in 928 registry patients treated</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>consecutively</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>across<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">4 Mass</span><span class="NormalTextRun SCXW6243700 BCX0">achusetts</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>General Brigham hospitals</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>between 2014 and 2023.</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="83959053" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{20}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">Preprocedural non</span><span class="NormalTextRun SCXW6243700 BCX0">-</span><span class="NormalTextRun SCXW6243700 BCX0">contrast CT scans were<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW6243700 BCX0">analyzed</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>using<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">a</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>deep learning algorithm to segment the entire aorta from the<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW6243700 BCX0">sinotubular</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>junction to the aortic bifurcation</span><span class="NormalTextRun SCXW6243700 BCX0">.</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>PAAT</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>was</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>defined as adipose voxels (</span><span class="NormalTextRun SCXW6243700 BCX0">-</span><span class="NormalTextRun SCXW6243700 BCX0">190 to<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">-</span><span class="NormalTextRun SCXW6243700 BCX0">30 HU) within a 10-mm periaortic mask, enabling quantification of PAAT attenuation and volume</span><span class="NormalTextRun SCXW6243700 BCX0">, the researchers said</span><span class="NormalTextRun SCXW6243700 BCX0">. </span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="1166250470" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{22}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">At baseline, the patients’ mean age was 81<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">(</span><span class="NormalTextRun SCXW6243700 BCX0">±8</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">years</span><span class="NormalTextRun SCXW6243700 BCX0">), 58% were male and 222 (23.9%) died. </span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="2088876193" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{24}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">The<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">PAAT attenuation was<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">-</span><span class="NormalTextRun SCXW6243700 BCX0">77.3 ± 7.2 HU and was higher in women (+2.1 ± 0.5 HU), non</span><span class="NormalTextRun SCXW6243700 BCX0">-</span><span class="NormalTextRun SCXW6243700 BCX0">obese patients (+4.7 ± 0.5 HU</span><span class="NormalTextRun SCXW6243700 BCX0">)</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>and those with moderate or high<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">Society of Thoracic Surgeons</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">(</span><span class="NormalTextRun SCXW6243700 BCX0">STS</span><span class="NormalTextRun SCXW6243700 BCX0">)</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>risk score</span><span class="NormalTextRun SCXW6243700 BCX0">s</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>(+1.7 ± 0.5 HU) (all P < 0.001).</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="2104751519" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{26}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">The researchers found<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">that<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">PAAT attenuation was independently associated with mortality<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">(per 10 HU: adjusted</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>hazard ratio</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">[</span><span class="NormalTextRun SCXW6243700 BCX0">HR</span><span class="NormalTextRun SCXW6243700 BCX0">]</span><span class="NormalTextRun SCXW6243700 BCX0">: 1.79</span><span class="NormalTextRun SCXW6243700 BCX0">;<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">95%<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">confidence interval [</span><span class="NormalTextRun SCXW6243700 BCX0">CI</span><span class="NormalTextRun SCXW6243700 BCX0">]</span><span class="NormalTextRun SCXW6243700 BCX0">: 1.33-2.41; P < 0.001)</span><span class="NormalTextRun SCXW6243700 BCX0">, “</span><span class="NormalTextRun SCXW6243700 BCX0">with consistent findings across thoracic and abdominal aortic segments</span><span class="NormalTextRun SCXW6243700 BCX0">”.</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="1765326081" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{28}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">T</span><span class="NormalTextRun SCXW6243700 BCX0">here was a</span><span class="NormalTextRun SCXW6243700 BCX0">lso a</span><span> </span><span class="NormalTextRun SCXW6243700 BCX0">significantly lower survival</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>rate for</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>patients with PAAT attenuation above the cohort median (</span><span class="NormalTextRun SCXW6243700 BCX0">-</span><span class="NormalTextRun SCXW6243700 BCX0">78 HU) compared with those below (</span><span class="NormalTextRun SpellingErrorV2Themed SCXW6243700 BCX0">logrank</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>P < 0.001)</span><span class="NormalTextRun SCXW6243700 BCX0">.</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="1168844036" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{30}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">PAAT attenuation also “</span><span class="NormalTextRun SCXW6243700 BCX0">modestly but significantly</span><span class="NormalTextRun SCXW6243700 BCX0">” improved discrimination beyond the STS score alone,<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">the researchers said.</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="1619185337" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{32}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">“T</span><span class="NormalTextRun SCXW6243700 BCX0">hese findings support PAAT attenuation as a novel imaging biomarker with potential to refine risk stratification in patients undergoing TAVR</span><span class="NormalTextRun SCXW6243700 BCX0">,” the researchers<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">wrote</span><span class="NormalTextRun SCXW6243700 BCX0">. They added that, for TAVR patients, who tend to have<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">significant comorbidity and systemic atherosclerosis</span><span class="NormalTextRun SCXW6243700 BCX0">, high PAAT attenuation could act as a surrogate of broader biological vulnerability.</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="1643373339" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{34}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">“</span><span class="NormalTextRun SCXW6243700 BCX0">The consistency of this signal with prior TAVR studies on epicardial adipose tissue density5 strengthens the biological plausibility that qualitative adipose characteristics contribute to long-term outcomes</span><span class="NormalTextRun SCXW6243700 BCX0">.</span><span class="NormalTextRun SCXW6243700 BCX0">”</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="1126660835" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{36}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">"A</span><span class="NormalTextRun SCXW6243700 BCX0">lthough PAAT is a local perivascular compartment, its attenuation<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">likely reflects</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>the cumulative effects of systemic atherosclerosis, chronic<span> </span></span><span class="NormalTextRun SCXW6243700 BCX0">inflammation</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>and vascular aging (</span><span class="NormalTextRun SCXW6243700 BCX0">‘</span><span class="NormalTextRun SCXW6243700 BCX0">inflammaging</span><span class="NormalTextRun SCXW6243700 BCX0">’</span><span class="NormalTextRun SCXW6243700 BCX0">) rather than isolated regional disease</span><span class="NormalTextRun SCXW6243700 BCX0">,” the researchers wrote.</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="1442282544" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{38}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">They pushed for further<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW6243700 BCX0">longitudinal</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>studies</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>into whether inflammation-modifying agents can alter PAAT attenuation and whether such changes can translate into improved outcomes.<span> </span></span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="282888735" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{40}"><strong><span class="NormalTextRun SCXW6243700 BCX0">Source:</span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" paraid="769892983" paraeid="{dc301003-ee56-4603-b45a-5e32aefdf219}{42}"><span data-contrast="auto" xml:lang="DE-CH" lang="DE-CH" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">Brendel JM, Hadzic I, Mayrhofer T</span><span class="NormalTextRun SCXW6243700 BCX0">, et al.<span> </span></span></span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">Re</span><span class="NormalTextRun SCXW6243700 BCX0">search Letter:</span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>Opportunistic CT-Derived Periaortic Fat Attenuation as a Novel Marker of Mortality in Patients Undergoing TAVR</span><span class="NormalTextRun SCXW6243700 BCX0">.<span> </span></span></span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0"><em>JACC:</em> <em>Cardiovasc </em></span><em><span class="NormalTextRun SpellingErrorV2Themed SCXW6243700 BCX0">Imag</span></em></span><span class="NormalTextRun SCXW6243700 BCX0"><span> </span>2026; DOI: 10.1016/j.jcmg.2026.03.004.</span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW6243700 BCX0"> <p class="Paragraph SCXW6243700 BCX0" lang="EN-US" paraid="2090429698" paraeid="{b700f526-156e-4e9b-a4a6-d808cd460113}{136}"><strong><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun MacChromeBold SCXW6243700 BCX0"><span class="NormalTextRun SCXW6243700 BCX0">Image Credit: </span><span class="NormalTextRun SCXW6243700 BCX0">Drazen</span><span class="NormalTextRun SCXW6243700 BCX0"> – stock.adobe.com</span></span><span class="EOP SCXW6243700 BCX0" data-ccp-props="{}"> </span></strong></p> </div>