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Myocardial Scar and Mortality in Severe Aortic Stenosis: Data from the BSCMR Valve Consortium

Overview of attention for article published in Circulation, July 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (83rd percentile)

Mentioned by

news
1 news outlet
twitter
100 tweeters

Readers on

mendeley
9 Mendeley
Title
Myocardial Scar and Mortality in Severe Aortic Stenosis: Data from the BSCMR Valve Consortium
Published in
Circulation, July 2018
DOI 10.1161/circulationaha.117.032839
Pubmed ID
Authors

Tarique A. Musa, Thomas A. Treibel, Vassiliou S. Vassiliou, Gabriella Captur, Anvesha Singh, Calvin Chin, Laura E. Dobson, Silvia Pica, Margaret Loudon, Tamir Malley, Marzia Rigolli, James R. J. Foley, Petra Bijsterveld, Graham R. Law, Marc Dweck, Saul G. Myerson, Gerry P. McCann, Sanjay K. Prasad, James C. Moon, John P. Greenwood

Abstract

Background -Aortic valve replacement (AVR) for aortic stenosis (AS) is timed primarily on the development of symptoms; but late surgery can result in irreversible myocardial dysfunction and additional risk. This study aimed to determine whether presence of focal myocardial scar pre-operatively was associated with long-term mortality. Methods -In a longitudinal observational outcome study, survival analysis was performed in patients with severe AS listed for valve intervention at six UK cardiothoracic centers. Patients underwent pre-procedure echocardiography (for valve severity assessment) and cardiovascular magnetic resonance for ventricular volumes, function and scar quantification between January 2003 and May 2015. Myocardial scar was categorized into three patterns (none, infarct or non-infarct patterns) and quantified using the full-width-at-half-maximum method as percentage of the left ventricle. All-cause and cardiovascular mortality were tracked for a minimum of 2 years. Results -674 patients with severe AS (75±14years, 63% male; AV area 0.38±0.14cm2/m2; mean gradient 46±18mmHg, LVEF 61.0±16.7%) were included. Scar was present in 51% (18% infarct-pattern; 33% non-infarct). Management was surgical (SAVR, n=399) or transcatheter (TAVR, n=275). During follow-up (median 3.6 years), 145 (21.5%) died (52 post-SAVR, 93 post-TAVR). At multivariable analysis, the factors independently associated with all-cause mortality were age (HR 1.50, 95%CI: 1.11-2.04, p=0.009; scaled by epochs of 10 years), STS score (HR 1.12, 95%CI 1.03-1.22, p=0.007) and scar presence (HR 2.39, 95%CI 1.40-4.05, p=0.001). Scar independently predicted all-cause (26.4% vs 12.9%; p<0.001) and cardiovascular mortality (15.0% vs 4.8%; p<0.001), regardless of intervention (TAVR p=0.002, SAVR p=0.026 [all-cause mortality]). Every 1% increase in LV myocardial scar burden was associated with 11% higher all-cause mortality hazard (HR 1.11; 95%CI: 1.05-1.17; p<0.001) and 8% higher cardiovascular mortality hazard (HR 1.08; 95%CI: 1.01-1.17; p<0.001). Conclusions -In patients with severe AS, late gadolinium enhancement on cardiovascular MR was independently associated with mortality; its presence being associated with a 2-fold higher late mortality.

Twitter Demographics

The data shown below were collected from the profiles of 100 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 9 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 9 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 4 44%
Other 2 22%
Researcher 2 22%
Professor > Associate Professor 1 11%
Readers by discipline Count As %
Medicine and Dentistry 8 89%
Unspecified 1 11%

Attention Score in Context

This research output has an Altmetric Attention Score of 76. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 October 2018.
All research outputs
#176,508
of 11,951,403 outputs
Outputs from Circulation
#519
of 15,135 outputs
Outputs of similar age
#8,230
of 247,765 outputs
Outputs of similar age from Circulation
#26
of 159 outputs
Altmetric has tracked 11,951,403 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 15,135 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.0. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 247,765 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 159 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 83% of its contemporaries.