Prognostic role of diastolic dysfunction in patients undergoing transcatheter aortic valve replacement

Autor: Manolis Vavuranakis, Polydoros N. Kampaktsis, Arash Salemi, S. Chiu Wong, Ines Sherifi, Daniel Y. Choi, Gerasimos Siasos, Dionysis Triantafyllou, Richard B. Devereux, Dimitrios Tousoulis, Angela Christofi
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Diastole
030204 cardiovascular system & hematology
Patient Readmission
Risk Assessment
Ventricular Function
Left
Transcatheter Aortic Valve Replacement
Ventricular Dysfunction
Left
03 medical and health sciences
0302 clinical medicine
Valve replacement
Aortic valve replacement
Risk Factors
Cause of Death
Mitral valve
Internal medicine
Ventricular Pressure
medicine
Humans
Radiology
Nuclear Medicine and imaging
030212 general & internal medicine
Aged
Retrospective Studies
Aged
80 and over
Heart Failure
business.industry
Calcinosis
Atrial fibrillation
Aortic Valve Stenosis
General Medicine
medicine.disease
Stenosis
Treatment Outcome
medicine.anatomical_structure
Aortic Valve
Heart failure
Cohort
cardiovascular system
Cardiology
Mitral Valve
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Catheterization and Cardiovascular Interventions. 95:1024-1031
ISSN: 1522-726X
1522-1946
Popis: Objectives Prior studies have shown that left ventricular diastolic dysfunction (DD) is associated with increased mortality after surgical aortic valve replacement but studies on transcatheter aortic valve replacement (TAVR) are limited and have not taken into account mitral annular calcification (MAC), which limits the use of mitral valve annular tissue Doppler imaging. We performed a single-center retrospective analysis to better evaluate the role of baseline DD on outcomes after TAVR. Methods After excluding patients with atrial fibrillation, mitral valve prostheses and significant mitral stenosis, 359 consecutive TAVR patients were included in the study. Moderate-to-severe MAC was present in 58% of the patients. We classified patients into severe versus nonsevere DD based on the evaluation of elevated left ventricular filling pressure. The outcome measure was all-cause mortality or heart failure hospitalization. Results Over a mean follow-up time of 13 months, severe DD was associated with an increased risk for the outcome measure (HR 2.02 [1.23-3.30], p = .005). However, this association was lost in a propensity-matched cohort. In multivariate analysis, STS score was the only independent predictor of all cause mortality of heart failure hospitalization (HR 1.1 [1.05-1.15], p Conclusions We evaluated the role of baseline DD on outcomes after TAVR by taking into account the presence of MAC. Severe DD was associated with increased all-cause mortality or heart failure hospitalization but not independently of other structural parameters and known predictors of the outcome measure.
Databáze: OpenAIRE
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