Discongruence Index - Simple Indicator to Predict Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement
BACKGROUND: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) remains an important issue. The aim of this study was to assess the value of a new discongruence index, to predict PPM after TAVR.Methods and Results: A total of 185 patients with severe aortic stenosis who underwent TAVR with the Edwards Sapien prosthesis or CoreValve Revalving system were included (Edwards valve, n=119; Core Valve Revalving system, n=66). Discongruence index was calculated pre-procedurally as the ratio of selected transcatheter valve size (mm) to body surface area (cm2). PPM was defined as effective orifice area (EOA) ≤0.85 cm2/m2 on transthoracic echocardiography before hospital discharge. Mean age was 82±5 years and 72 patients (38.9%) were men. The overall incidence of post-TAVR PPM was 35.1% (n=65). Discongruence index correlated with post-TAVR indexed EOA (y=0.18+0.057x; P<0.001). On multivariate logistic regression analysis, discongruence index was the only independent predictor of post-TAVR PPM (OR, 0.15; 95% CI: 0.03-0.66; P=0.012), and the area under the receiver operating characteristic curve was 0.62 (95% CI: 0.54-0.70, P=0.003), with an optimal cut-off point of 15.02 (sensitivity, 86.2%; specificity, 72.5%; positive predictive value, 74.3%; negative predictive value, 83.4%).
CONCLUSIONS: The new discongruence index may be useful tool to predict PPM after TAVR.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:82 |
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| Enthalten in: |
Circulation journal : official journal of the Japanese Circulation Society - 82(2018), 11 vom: 25. Okt., Seite 2880-2886 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
de Agustin, Jose Alberto [VerfasserIn] |
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| Links: |
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| Themen: |
Clinical Trial |
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| Anmerkungen: |
Date Completed 12.11.2019 Date Revised 12.11.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1253/circj.CJ-18-0298 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM287736792 |
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| 520 | |a BACKGROUND: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) remains an important issue. The aim of this study was to assess the value of a new discongruence index, to predict PPM after TAVR.Methods and Results: A total of 185 patients with severe aortic stenosis who underwent TAVR with the Edwards Sapien prosthesis or CoreValve Revalving system were included (Edwards valve, n=119; Core Valve Revalving system, n=66). Discongruence index was calculated pre-procedurally as the ratio of selected transcatheter valve size (mm) to body surface area (cm2). PPM was defined as effective orifice area (EOA) ≤0.85 cm2/m2 on transthoracic echocardiography before hospital discharge. Mean age was 82±5 years and 72 patients (38.9%) were men. The overall incidence of post-TAVR PPM was 35.1% (n=65). Discongruence index correlated with post-TAVR indexed EOA (y=0.18+0.057x; P<0.001). On multivariate logistic regression analysis, discongruence index was the only independent predictor of post-TAVR PPM (OR, 0.15; 95% CI: 0.03-0.66; P=0.012), and the area under the receiver operating characteristic curve was 0.62 (95% CI: 0.54-0.70, P=0.003), with an optimal cut-off point of 15.02 (sensitivity, 86.2%; specificity, 72.5%; positive predictive value, 74.3%; negative predictive value, 83.4%) | ||
| 520 | |a CONCLUSIONS: The new discongruence index may be useful tool to predict PPM after TAVR | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Discongruence index | |
| 650 | 4 | |a Echocardiography | |
| 650 | 4 | |a Prosthesis-patient mismatch | |
| 650 | 4 | |a Transcatheter aortic valve replacement | |
| 700 | 1 | |a Islas, Fabian |e verfasserin |4 aut | |
| 700 | 1 | |a Jimenez-Quevedo, Pilar |e verfasserin |4 aut | |
| 700 | 1 | |a Nombela-Franco, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Rueda Liñares, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Mahia, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Marcos-Alberca, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Pozo, Eduardo |e verfasserin |4 aut | |
| 700 | 1 | |a Gomez de Diego, Jose Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Luaces, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Nuñez-Gil, Ivan-Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Fernandez, Miguel Ángel |e verfasserin |4 aut | |
| 700 | 1 | |a Fernandez-Ortiz, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Macaya, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Perez de Isla, Leopoldo |e verfasserin |4 aut | |
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