Impact of left ventricular systolic function on clinical and echocardiographic outcomes following transcatheter aortic valve implantation for severe aortic stenosis

Ewe, See Hooi, Marsan, Nina Ajmone, Pepi, Mauro, Delgado, Victoria, Tamborini, Gloria, Muratori, Manuela, Ng, Arnold C. T., van der Kley, Frank, de Weger, Arend, Schalij, Martin J., Fusari, Melissa, Biglioli, Paolo and Bax, Jeroen J. (2010) Impact of left ventricular systolic function on clinical and echocardiographic outcomes following transcatheter aortic valve implantation for severe aortic stenosis. American Heart Journal, 160 6: 1113-1120. doi:10.1016/j.ahj.2010.09.003


Author Ewe, See Hooi
Marsan, Nina Ajmone
Pepi, Mauro
Delgado, Victoria
Tamborini, Gloria
Muratori, Manuela
Ng, Arnold C. T.
van der Kley, Frank
de Weger, Arend
Schalij, Martin J.
Fusari, Melissa
Biglioli, Paolo
Bax, Jeroen J.
Title Impact of left ventricular systolic function on clinical and echocardiographic outcomes following transcatheter aortic valve implantation for severe aortic stenosis
Journal name American Heart Journal   Check publisher's open access policy
ISSN 0002-8703
1097-6744
Publication date 2010-12
Sub-type Article (original research)
DOI 10.1016/j.ahj.2010.09.003
Volume 160
Issue 6
Start page 1113
End page 1120
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Formatted abstract
Background This study aimed to evaluate the impact of baseline left ventricular (LV) systolic function on clinical and echocardiographic outcomes following transcatheter aortic valve implantation (TAVI). Survival of patients undergoing TAVI was also compared with that of a population undergoing surgical aortic valve replacement.
Methods One hundred forty-seven consecutive patients (mean age = 80 ± 7 years) undergoing TAVI in 2 centers were included. Mean follow-up period was 9.1 ± 5.1 months.
Results At baseline, 34% of patients had impaired LV ejection fraction (LVEF) (<50%) and 66% had normal LVEF (≥50%). Procedural success was similar in these 2 groups (94% vs 97%, P = .41). All patients achieved improvement in transvalvular hemodynamics. At follow-up, patients with a baseline LVEF <50% showed marked LV reverse remodeling, with improvement of LVEF (from 37% ± 8% to 51% ± 11%). Early and late mortality rates were not different between the 2 groups, despite a higher rate of combined major adverse cardiovascular events (MACEs) in patients with a baseline LVEF <50%. The predictors of cumulative MACEs were baseline LVEF (HR = 0.97, 95% CI = 0.94-0.99) and preoperative frailty (HR = 4.20, 95% CI = 2.00-8.84). In addition, long-term survival of patients with impaired or normal LVEF was comparable with that of a matched population who underwent surgical aortic valve replacement.
Conclusions TAVI resulted in significant improvement in LV function and survival benefit in high-risk patients with severe aortic stenosis, regardless of baseline LVEF. Patients with a baseline LVEF <50% were at higher risk of combined MACEs.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: School of Medicine Publications
Centre for Advanced Imaging Publications
 
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Created: Sun, 14 Apr 2013, 23:56:57 EST by Dr Chin Tse Arnold Ng on behalf of Centre for Advanced Imaging