Diastolic Dysfunction and Health Status Outcomes After Transcatheter Aortic Valve Replacement.

Autor:	El-Zein RS; Division of Cardiology, University of Missouri-Kansas City, Missouri, USA.; Division of Cardiology, Saint Luke's Mid America Heart Institute, Missouri, USA., Malik AO; Division of Cardiology, University of Missouri-Kansas City, Missouri, USA.; Division of Cardiology, Saint Luke's Mid America Heart Institute, Missouri, USA., Cohen DJ; Division of Cardiology, Saint Francis Hospital, New York, USA.; Clinical Trials Center, Cardiovascular Research Foundation, New York, USA., Spertus JA; Division of Cardiology, University of Missouri-Kansas City, Missouri, USA.; Division of Cardiology, Saint Luke's Mid America Heart Institute, Missouri, USA., Saxon JT; Division of Cardiology, Saint Luke's Mid America Heart Institute, Missouri, USA., Pibarot P; Division of Cardiology, Laval University, Quebec, Canada., Hahn RT; Clinical Trials Center, Cardiovascular Research Foundation, New York, USA.; Division of Cardiology, Columbia University Irving Medical Center, New York, USA., Alu MC; Clinical Trials Center, Cardiovascular Research Foundation, New York, USA., Shang K; Edwards Lifesciences, California, USA., Kodali SK; Division of Cardiology, Columbia University Irving Medical Center, New York, USA., Thourani VH; Division of Cardiothoracic Surgery, Piedmont Heart Institute, Georgia, USA., Leon MB; Clinical Trials Center, Cardiovascular Research Foundation, New York, USA.; Division of Cardiology, Columbia University Irving Medical Center, New York, USA., Mack MJ; Division of Cardiothoracic Surgery, Baylor Scott & White Health, Texas, USA., Chhatriwalla AK; Division of Cardiology, University of Missouri-Kansas City, Missouri, USA.; Division of Cardiology, Saint Luke's Mid America Heart Institute, Missouri, USA.
Jazyk:	angličtina
Zdroj:	Structural heart : the journal of the Heart Team [Struct Heart] 2023 Sep 27; Vol. 8 (1), pp. 100225. Date of Electronic Publication: 2023 Sep 27 (Print Publication: 2024).
DOI:	10.1016/j.shj.2023.100225
Abstrakt:	Background: Baseline left ventricular diastolic dysfunction (LVDD) is associated with poor health status in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR), but health status improvement after TAVR appears similar across all grades of LVDD. Here, we aim to examine the relationship between changes in LVDD severity and health status outcomes following TAVR. Methods: Patients who underwent TAVR and had evaluable LVDD at both baseline and 1 year in the PARTNER (Placement of Aortic Transcatheter Valves) 2 SAPIEN 3 registries and PARTNER 3 trial were analyzed. LVDD grade was evaluated using echocardiography core lab data and an adapted definition of American Society of Echocardiography guidelines. Health status was assessed using the Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ-OS) score. The association between ΔLVDD severity and ΔKCCQ-OS was examined using linear regression models adjusted for baseline KCCQ-OS. Results: Of 1100 patients, 724 (65.8%), 283 (25.7%), and 93 (8.5%) had grade 0/1, 2, and 3 LVDD at baseline, respectively. At 1 year, LVDD severity was unchanged in 790 (71.8%) patients, improved in 189 (17.2%), and worsened in 121 (11.0%). Among 376 patients with baseline grade 2 or 3 LVDD, 50.3% had improvement in LVDD. In the overall cohort, KCCQ-OS score improved by 21.9 points at 1 year. There was a statistically significant association between change in LVDD severity (improved, unchanged, and worsened) and ΔKCCQ-OS at 1 year ( p = 0.007). Conclusions: Change in LVDD grade was associated with change in health status 1 year following TAVR. Competing Interests: David J. Cohen receives research grant support from 10.13039/100006520Edwards Lifesciences, 10.13039/100000046Abbott, 10.13039/100008497Boston Scientific, and 10.13039/100004374Medtronic and Consulting income from Edwards Lifesciences, Abbott, Boston Scientific, and Medtronic. John A. Spertus is the PI of grants from 10.13039/100000002NIH, 10.13039/100011949Abbott Vascular, and the 10.13039/100005485American College of Cardiology Foundation; is a consultant to Janssen, Novartis, Amgen, Bristol Meyers Squibb, AstraZeneca, Bayer and Merck; serves on the Scientific Advisory Board of United Healthcare and the Board of Directors for Blue Cross Blue Shield of Kansas City; and owns the copyright to the KCCQ, SAQ, and PAQ. Philippe Pibarot has received funding from 10.13039/100006520Edwards Lifesciences, 10.13039/100004374Medtronic, Pi-Cardia, and Cardiac Phoenix for echocardiography core laboratory analyses and research studies in the field of transcatheter valve therapies, for which he received no personal compensation. Philippe Pibarot has received lecture fees from Edwards Lifesciences and Medtronic. Rebecca T. Hahn reports speaker fees from Abbott Structural, Baylis Medical, Edwards Lifesciences, and Philips Healthcare; she has institutional consulting contracts for which she receives no direct compensation with Abbott Structural, Boston Scientific, Edwards Lifesciences, Medtronic and Novartis; she has stock options with Navigate; and is Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored trials, for which she receives no direct industry compensation. Maria C. Alu reports institutional research funding from 10.13039/100006520Edwards Lifesciences (no direct compensation). Kan Shang is an employee of Edwards Lifesciences. Susheel K. Kodali reports institutional research grants from 10.13039/100006520Edwards Lifesciences, 10.13039/100004374Medtronic, and 10.13039/100000046Abbott, consulting fees from Abbott, Admedus, and Meril Lifesciences, and equity options from Biotrace Medical and Thubrikar Aortic Valve Inc. Vinod H Thourani reports research and/or consulting from Abbott Vascular, Artivion, Atricure, Boston Scientific, Edwards Lifesciences, HighLife, Jenavalve, Medtronic, and Shockwave. Martin B. Leon serves on the PARTNER Trial Executive Committee - Edwards Lifesciences (nonpaid) and reports institutional research grants and being a nonpaid advisor for 10.13039/100000046Abbott, 10.13039/100008497Boston Scientific, and 10.13039/100004374Medtronic; nonpaid advisor for Sinomed, and equity in Medinol. Michael J. Mack served as co-primary investigator for the PARTNER trial for Edwards Lifesciences and COAPT trial for Abbott; served as study chair for the APOLLO trial for Medtronic (all activities unpaid). Adnan K. Chhatriwalla Speakers Bureau: Abbott Vascular, Edwards Lifesciences, Medtronic Inc.; Proctor: Edwards Lifesciences, Medtronic Inc.; Research Grant: 10.13039/100008497Boston Scientific. The other authors had no conflicts to declare. (© 2023 The Author(s).)
Databáze:	MEDLINE
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