Predictors of early mortality after transcatheter aortic valve implantation
| Autor: | Siri Malm, Terje K. Steigen, Assami Rösner, Gry Dahle, Jo Eidet, Rolf Busund, Lars Aaberge, Svend Aakhus, Didrik Kjønås, Henrik Schirmer |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Diastole 030204 cardiovascular system & hematology TAVI 03 medical and health sciences 0302 clinical medicine quality and outcome medicine.artery Internal medicine Epidemiology medicine Clinical endpoint echocardiography 030212 general & internal medicine VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771 VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771 business.industry medicine.disease Stenosis Valvular Heart Disease Heart failure Pulmonary artery Cardiology epidemiology Cardiology and Cardiovascular Medicine business Body mass index Cohort study |
| Zdroj: | Open heart Open Heart |
| ISSN: | 2053-3624 |
| Popis: | ObjectivesTo investigate whether preoperative echocardiographic evaluation of ventricular function, especially right ventricular systolic and diastolic parameters including speckle-tracking analysis, could aid in the prediction of 30-day mortality after transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis.MethodsThis is a prospective observational cohort study including 227 patients accepted for TAVI at the University Hospital of North Norway and Oslo University Hospital from February 2010 through June 2013. All patients underwent preoperative transthoracic echocardiography with retrospective speckle-tracking analysis. Primary endpoint was all-cause 30-day mortality.ResultsAll-cause 30-day mortality was 8.7 % (n = 19). Independent predictors of 30-day mortality were systolic pulmonary arterial pressure (SPAP) > 60 mm Hg (HR: 7.7, 95% CI: 1.90 to 31.3), heart failure (HR: 2.9, 95% CI: 1.1 to 7.78), transapical access (HR: 3.8, 95% CI: 1.3 to 11.2), peripheral artery disease (HR: 6.0, 95% CI: 2.0 to 18.0) and body mass index (HR: 0.73, 95% CI: 0.61 to 0.87). C-statistic for the model generated was 0.91 (95% CI: 0.85 to 0.98). Besides elevated SPAP, no other echocardiographic measurements were found to be an independent predictor of early mortality.ConclusionExcept for elevated systolic pulmonary artery pressure, our data suggests that clinical rather than echocardiographic parameters are useful predictors of 30-day mortality after TAVI. |
| Databáze: | OpenAIRE |
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