Transcatheter aortic valve implantation outcomes in patients with low flow low gradient aortic stenosis
Copyright © 2022 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved..
BACKGROUND: Some studies suggest that patients with low flow low gradient (LF-LG) aortic stenosis (AS) may achieve worse results after undergoing transcatheter aortic valve implantation (TAVI).
PURPOSE: To compare outcomes between LF-LG AS and high gradient (HG) AS patients submitted to TAVI.
METHODS: Inclusion of 480 consecutive patients who underwent TAVI between 2008 and 2020 at a single tertiary center. Patients were divided into high gradient AS and LF-LG AS; and baseline characteristics and outcomes after the procedure were collected and compared between groups.
RESULTS: Patients with LF-LG AS had worse baseline characteristics, with higher Society of Thoracic Surgeons score (p=0.008), New Euroscore II (p<0.0001), and NT pro-natriuretic peptide B (p=0.001), more frequent left ventricular ejection fraction (LVEF) <40% (p<0.0001), coronary artery disease (p<0.0001), including previous myocardial infarction (p=0.002) and coronary artery bypass graft (p<0.0001), poor vascular accesses (p=0.026) and periprocedural angioplasty (p=0.038). In a multivariate analysis, adjusted to differences in baseline characteristics, LF-LG AS was associated with worse functional class at one year (p=0.023) and in the long-term (p=0.004) and with heart failure hospitalizations at one year and in the long-term (p=0.001 and p<0.0001). In a sub-analysis including only patients with LF-LG AS, those with LVEF <40% had the worst outcomes, with more global (p=0.035) and cardiovascular (p=0.038) mortality.
CONCLUSION: Patients with LF-LG AS have worse short and long-term outcomes, even when adjusted for baseline characteristic differences. The sub-group of patients with LVEF <40% have the most ominous global outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
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| Enthalten in: |
Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology - 41(2022), 8 vom: 03. Aug., Seite 621-631 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Castelo, Alexandra [VerfasserIn] |
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| Links: |
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| Themen: |
Aortic stenosis |
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| Anmerkungen: |
Date Revised 08.09.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.repc.2022.03.002 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM345903587 |
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| 245 | 1 | 0 | |a Transcatheter aortic valve implantation outcomes in patients with low flow low gradient aortic stenosis |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2022 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a BACKGROUND: Some studies suggest that patients with low flow low gradient (LF-LG) aortic stenosis (AS) may achieve worse results after undergoing transcatheter aortic valve implantation (TAVI) | ||
| 520 | |a PURPOSE: To compare outcomes between LF-LG AS and high gradient (HG) AS patients submitted to TAVI | ||
| 520 | |a METHODS: Inclusion of 480 consecutive patients who underwent TAVI between 2008 and 2020 at a single tertiary center. Patients were divided into high gradient AS and LF-LG AS; and baseline characteristics and outcomes after the procedure were collected and compared between groups | ||
| 520 | |a RESULTS: Patients with LF-LG AS had worse baseline characteristics, with higher Society of Thoracic Surgeons score (p=0.008), New Euroscore II (p<0.0001), and NT pro-natriuretic peptide B (p=0.001), more frequent left ventricular ejection fraction (LVEF) <40% (p<0.0001), coronary artery disease (p<0.0001), including previous myocardial infarction (p=0.002) and coronary artery bypass graft (p<0.0001), poor vascular accesses (p=0.026) and periprocedural angioplasty (p=0.038). In a multivariate analysis, adjusted to differences in baseline characteristics, LF-LG AS was associated with worse functional class at one year (p=0.023) and in the long-term (p=0.004) and with heart failure hospitalizations at one year and in the long-term (p=0.001 and p<0.0001). In a sub-analysis including only patients with LF-LG AS, those with LVEF <40% had the worst outcomes, with more global (p=0.035) and cardiovascular (p=0.038) mortality | ||
| 520 | |a CONCLUSION: Patients with LF-LG AS have worse short and long-term outcomes, even when adjusted for baseline characteristic differences. The sub-group of patients with LVEF <40% have the most ominous global outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Aortic stenosis | |
| 650 | 4 | |a Baixo fluxo-baixo gradiente | |
| 650 | 4 | |a Estenose aórtica | |
| 650 | 4 | |a Low flow low gradient | |
| 650 | 4 | |a Transcatheter aortic valve implantation | |
| 650 | 4 | |a Válvula aórtica percutânea | |
| 700 | 1 | |a Grazina, André |e verfasserin |4 aut | |
| 700 | 1 | |a Mendonça, Tiago |e verfasserin |4 aut | |
| 700 | 1 | |a Rodrigues, Inês |e verfasserin |4 aut | |
| 700 | 1 | |a Brás, Pedro Garcia |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreira, Vera Vaz |e verfasserin |4 aut | |
| 700 | 1 | |a Ramos, Rúben |e verfasserin |4 aut | |
| 700 | 1 | |a Fiarresga, António |e verfasserin |4 aut | |
| 700 | 1 | |a Cacela, Duarte |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreira, Rui Cruz |e verfasserin |4 aut | |
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