The Determinants and Outcomes of Myocardial Injury After Transcatheter Aortic-Valve Implantation: SAPIEN 3 Study

Autor: Yoshio Ikeda, Sho Yuasa, Satoshi Fujita, Minoru Takahashi, Yuji Taya, Yoshifusa Aizawa, Hitoshi Kitazawa, Masaaki Okabe, Takao Sato
Rok vydání: 2020
Předmět:
Male
Aortic valve
medicine.medical_specialty
Time Factors
Heart Diseases
Transcatheter aortic
medicine.drug_class
medicine.medical_treatment
030204 cardiovascular system & hematology
Risk Assessment
Ventricular Function
Left
Rapid pacing
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Troponin T
Risk Factors
Internal medicine
Natriuretic Peptide
Brain
Natriuretic peptide
Humans
Medicine
030212 general & internal medicine
Retrospective Studies
Aged
80 and over
business.industry
Significant difference
Recovery of Function
General Medicine
medicine.disease
Peptide Fragments
Aortic valvuloplasty
Treatment Outcome
medicine.anatomical_structure
Ventricle
Aortic Valve
Aortic valve stenosis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Biomarkers
Zdroj: Cardiovascular Revascularization Medicine. 21:973-979
ISSN: 1553-8389
DOI: 10.1016/j.carrev.2019.12.028
Popis: Background The effect of myocardial injury (MI) post-transcatheter aortic valve implantation (TAVI) on clinical outcomes is controversial. This study aimed to evaluate the effect of MI severity on clinical outcome and left ventricle function 30 days post-TAVI and determine MI post-TAVI predictors. Methods Overall, 138 consecutive patients who underwent successful transfemoral TAVI using SAPIEN3 and diagnosed using echocardiography and computed tomography were analyzed. High-sensitivity cardiac troponin T (TnT) was evaluated at baseline, immediately, and at 24, 48, and 72 h post-TAVI. Echocardiography findings and N-terminal pro-B-type natriuretic peptide (Nt-pro BNP) levels were evaluated 30 days post-TAVI. Results Mean age and STS score were 84.4 ± 3.5 years and 6.4 ± 3.2%, respectively. All cases showed severe aortic valve stenosis. Peri-procedural MI was observed in 48 of 100 patients (48.0%). Patients were grouped into MI (n = 48) and non-MI (n = 52), without significant difference in characteristics. Pre-balloon aortic valvuloplasty rate and total pacing time were significantly higher in MI vs non-MI. Total rapid pacing time (TRPT) was an independent predictor for MI (OR 1.06; 95% CI 1.01–1.16; p = 0.04). Echocardiography and Nt-pro BNP changes 30 days post-TAVI were similar between groups. Conclusion Peri-procedural MI, assessed by TnT changes, was observed in 48% of patients. The MI was not associated with overt cardiac dysfunction, and the recovery of left ventricular function and Nt-pro BNP level occurred similarly by 30 day post-TAVI between both groups. In multivariate analysis, TRPT was associated with MI after SAPIEN3 implantation. Trial registration number UMIN000036669.
Databáze: OpenAIRE
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