Update on Prosthesis-Patient Mismatch Following Transcatheter Aortic Valve Replacement in Asian Patients.

Autor: Ishizu K; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Kitano K; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Yamamoto K; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Hayashi M; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Shirai S; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Ohno N; Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan., Kakumoto S; Department of Anesthesiology, Kokura Memorial Hospital, Kitakyushu, Japan., Ando K; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Yashima F; Department of Cardiology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan., Nishina H; Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan., Izumo M; Department of Cardiology, St Marianna University, Kawasaki, Japan., Asami M; Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan., Tada N; Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan., Yamawaki M; Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan., Naganuma T; Department of Cardiology, New Tokyo Hospital, Matsudo, Japan., Yamanaka F; Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan., Ohno Y; Department of Cardiology, Tokai University School of Medicine, Isehara, Japan., Ueno H; Department of Cardiology, Toyama University Hospital, Toyama, Japan., Noguchi M; Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan., Mizutani K; Division of Cardiology, Department of Medicine, Kindai University, Osakasayama, Japan., Takagi K; Department of Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan., Watanabe Y; Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan., Yamamoto M; Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.; Department of Cardiology, Nagoya Heart Center, Nagoya, Japan.; Department of Cardiology, Gifu Heart Center, Gifu, Japan., Hayashida K; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Jazyk: angličtina
Zdroj: JACC. Asia [JACC Asia] 2024 Oct 08; Vol. 4 (11), pp. 793-806. Date of Electronic Publication: 2024 Oct 08 (Print Publication: 2024).
DOI: 10.1016/j.jacasi.2024.08.010
Abstrakt: Background: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) is of greater concern in Asians, considering their relatively smaller annular sizes compared with Westerners. However, the prognostic significance of PPM in Asian populations has not been demonstrated.
Objectives: This study aimed to elucidate the prognostic value of PPM after TAVR in Asian patients.
Methods: Patients undergoing TAVR from October 2013 to December 2019 were enrolled from the OCEAN-TAVI (Optimized CathEter vAlvular iNtervention-Transcatheter Aortic Valve Implantation) registry. PPM was classified based on the indexed effective orifice area as severe (≤0.65 cm 2 /m 2 ) or moderate (0.66-0.85 cm 2 /m 2 ) in the general population, and severe (≤0.55 cm 2 /m 2 ) or moderate (0.56-0.70 cm 2 /m 2 ) in the obese population (body mass index of ≥30 kg/m 2 ).
Results: Of the 7,072 eligible patients, moderate and severe PPM were identified in 742 (10.5%) and 94 (1.3%) patients, respectively. Severe PPM relative to non-PPM was independently associated with higher adjusted risks for 3-year all-cause mortality (adjusted HR: 1.79; 95% CI: 1.16-2.78; P  = 0.009) and heart failure hospitalization (adjusted HR: 1.88; 95% CI: 1.07-3.28; P  = 0.027), whereas no significant difference in these outcomes was observed between moderate PPM and no PPM.
Conclusions: Severe PPM following TAVR was observed in only 1.3% of our Japanese cohort, but was associated with an increased risk of mortality and heart failure hospitalization at 3 years. These results warrant the implementation of preventive strategies to obviate severe PPM after TAVR, also in Asian patients.
Competing Interests: The OCEAN-TAVI registry is supported by Edwards Lifesciences, Medtronic, Boston Scientific, Abbott Medical, and Daiichi-Sankyo Company. Dr Izumo is a screening proctor for Edwards Lifesciences. Drs Yohei Ohno, Yashima, and Asami are clinical proctors for Medtronic. Drs Naganuma, Ueno, Mizutani, and Takagi are clinical proctors for Edwards Lifesciences and Medtronic. Drs Masanori Yamamoto, Shirai, Tada, Watanabe, and Hayashida are clinical proctors for Edwards Lifesciences, Abbott Medical, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(© 2024 The Authors.)
Databáze: MEDLINE