Long-Term Impact of Cardiac Damage Following Transcatheter Aortic Valve Replacement.
| Autor: | Nakase M; Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: https://twitter.com/masaaki0825., Tomii D; Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: https://twitter.com/DaijiroTomii., Heg D; Clinical Trials Unit' Bern, University of Bern, Bern, Switzerland., Praz F; Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland., Stortecky S; Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland., Reineke D; Department of Cardiac Surgery, Inselspital, University of Bern, Bern, Switzerland., Samim D; Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland., Lanz J; Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland., Windecker S; Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland., Pilgrim T; Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. Electronic address: thomas.pilgrim@insel.ch. |
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| Jazyk: | angličtina |
| Zdroj: | JACC. Cardiovascular interventions [JACC Cardiovasc Interv] 2024 Apr 22; Vol. 17 (8), pp. 992-1003. |
| DOI: | 10.1016/j.jcin.2024.02.011 |
| Abstrakt: | Background: Extravalvular cardiac damage caused by aortic stenosis affects prognosis after transcatheter aortic valve replacement (TAVR). The long-term impact of changes in cardiac damage in response to relief from mechanical obstruction has not been fully investigated. Objectives: The authors aimed to investigate changes in cardiac damage early after TAVR and the prognostic impact of the cardiac damage classification after TAVR. Methods: In this single-center observational study, patients undergoing transfemoral TAVR were retrospectively evaluated for cardiac damage before and after TAVR and classified into 5 stages of cardiac damage (0-4). Results: Among 1,863 patients undergoing TAVR between January 2007 and June 2022, 56 patients (3.0%) were classified as stage 0, 225 (12.1%) as stage 1, 729 (39.1%) as stage 2, 388 (20.8%) as stage 3, and 465 (25.0%) as stage 4. Cardiac stage changed in 47.7% of patients (improved: 30.1% in stages 1-4 and deteriorated: 24.7% in stages 0-3) early after TAVR. Five-year all-cause mortality was associated with cardiac damage both at baseline (HR Conclusions: The extent of extra-aortic valve cardiac damage before and after TAVR and changes in cardiac stage early after TAVR have important prognostic implications during long-term follow-up. (SwissTAVI Registry; NCT01368250). Competing Interests: Funding Support and Author Disclosures Dr Heg has no personal conflicts; his employer, Clinical Trials Unit Bern, University of Bern, has a staff policy of not accepting honoraria or consultancy fees. However, Clinical Trials Unit Bern is involved in the design, conduct, or analysis of clinical studies funded by not-for-profit and for-profit organizations. In particular, pharmaceutical and medical device companies provide direct funding to some of these studies. Dr Praz has received travel expenses from Abbott, Edwards Lifesciences, and Polares Medical. Dr Stortecky has reported research grants to the institution from Edwards Lifesciences and Medtronic; and has received personal fees from Boston Scientific, Teleflex, and BTG. Dr Samim has received funding for an online course from Edwards Lifesciences. Dr Windecker has reported research, travel, or educational grants to the institution without personal remuneration from Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Braun, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Cordis Medical, Corflow Therapeutics, CSL Behring, Daiichi-Sankyo, Edwards Lifesciences, Farapulse Inc, Fumedica, Guerbet, Idorsia, Inari Medical, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medalliance, Medicure, Medtronic, Merck Sharp & Dohme, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pharming Tech, Pfizer, Polares, Regeneron, Sanofi-Aventis, Servier, Sinomed, Terumo, Vifor, and V-Wave. Dr Windecker has served as an Advisory Board member and/or member of the Steering/Executive Group of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, and V-Wave with payments to the institution but no personal payments; and is a member of the Steering/Executive Committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. Dr Pilgrim has reported research grants to the institution from Edwards Lifesciences, Boston Scientific, and Biotronik; and has received speaker fees/consultancy from Biotronik, Medtronic, Abbott, Edwards Lifesciences, and HighLife SAS. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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