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1000
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Abstract/Summary
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<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Aims</jats:title>
<jats:p>Transcatheter aortic valve implantation (TAVI) has emerged as the treatment of choice for many patients with severe symptomatic aortic stenosis. We sought to identify the echocardiographic predictors of 30-day and 1-year outcomes after TAVI in patients with preserved or reduced left ventricular ejection fraction (LVEF).</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>This single-centre study included 618 aortic stenosis patients (mean age 82 ± 6 years, 47.1% male; 74.8% LVEF > 50%) who underwent balloon-expandable TAVI between July 2009 and October 2018 in our hospital. All patients completed at least 6 months of follow-up by medical history review or telephone interview (median 24, quartiles 12–42 months). The primary endpoint was all-cause death.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>All-cause mortality rate was 5.2% (LVEF > 50%: 4.3% vs. LVEF ≤ 50%: 7.7%, <jats:italic>p</jats:italic> = 0.141) at 30 days and 15.4% (LVEF > 50%: 14.7% vs. LVEF ≤ 50%: 17.3%, <jats:italic>p</jats:italic> = 0.443) at 12 months post TAVI. Overall all-cause mortality rate was 45.1% (LVEF > 50%: 44.6% vs. LVEF ≤ 50%: 46.8%, <jats:italic>p</jats:italic> = 0.643). Mean survival time post TAVI was 51 months [95% CI (48; 55)]. In TAVI patients with LVEF > 50%, multivariate Cox regression analysis revealed several independent predictors for increased risk of death after adjusting for echocardiographic and clinical covariates: TAPSE (≤ 17 vs. > 17 mm, HR 1.528, <jats:italic>p</jats:italic> = 0.016) and sPAP (> 30 vs. ≤ 30 mmHg, HR 1.900, <jats:italic>p</jats:italic> = 0.002) for overall mortality, E/E′ septal for 30-day mortality (> 21 vs. ≤ 21, HR 14.462, <jats:italic>p</jats:italic> = 0.010) and 12-month mortality (> 21 vs. ≤ 21, HR 1.881, <jats:italic>p</jats:italic> = 0.026). In TAVI patients with LVEF ≤ 50%, no independent echocardiographic predictors for outcome could be identified.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>LVEF is not a predictor of short- and long-term mortality after TAVI. In patients with preserved LVEF, left ventricular filling pressure (E/E´), systolic pulmonary artery pressure (sPAP), and TAPSE are echocardiographic risk factors for increased mortality post TAVI.</jats:p>
</jats:sec><jats:sec>
<jats:title>Graphical abstract</jats:title>
</jats:sec>
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1000
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Hinweis
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DeepGreen-ID: 6978d9465f9e44ba8be7ca555b7cd6d0 ; metadata provieded by: DeepGreen (https://www.oa-deepgreen.de/api/v1/), LIVIVO search scope life sciences (http://z3950.zbmed.de:6210/livivo), Crossref Unified Resource API (https://api.crossref.org/swagger-ui/index.html), to.science.api (https://frl.publisso.de/), ZDB JSON-API (beta) (https://zeitschriftendatenbank.de/api/), lobid - Dateninfrastruktur für Bibliotheken (https://lobid.org/resources/search)
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