Clinical and Echocardiographic Parameters Predicting 1- and 2-Year Mortality After Transcatheter Aortic Valve Implantation
Background: Transcatheter aortic valve implantation (TAVI) has become a standard treatment option for patients with symptomatic aortic stenosis. Elderly high-risk patients treated with TAVI have a high residual mortality due to preexisting comorbidities. Knowledge of factors predicting futility afte...
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crfrontiers:10.3389/fcvm.2021.739710 2024-03-31T07:54:25+00:00 Clinical and Echocardiographic Parameters Predicting 1- and 2-Year Mortality After Transcatheter Aortic Valve Implantation Kjønås, Didrik Schirmer, Henrik Aakhus, Svend Eidet, Jo Malm, Siri Aaberge, Lars Busund, Rolf Rösner, Assami Helse Nord RHF 2021 http://dx.doi.org/10.3389/fcvm.2021.739710 https://www.frontiersin.org/articles/10.3389/fcvm.2021.739710/full unknown Frontiers Media SA https://creativecommons.org/licenses/by/4.0/ Frontiers in Cardiovascular Medicine volume 8 ISSN 2297-055X Cardiology and Cardiovascular Medicine journal-article 2021 crfrontiers https://doi.org/10.3389/fcvm.2021.739710 2024-03-05T00:12:49Z Background: Transcatheter aortic valve implantation (TAVI) has become a standard treatment option for patients with symptomatic aortic stenosis. Elderly high-risk patients treated with TAVI have a high residual mortality due to preexisting comorbidities. Knowledge of factors predicting futility after TAVI is sparse and clinical tools to aid the preoperative evaluation are lacking. The aim of this study was to evaluate if echocardiographic measures, including speckle-tracking analysis, in addition to clinical parameters, could aid in the prediction of mortality beyond 30 days after TAVI. Methods: This prospective observational cohort study included 227 patients treated with TAVI at the University Hospital of North Norway, Tromsø and Oslo University Hospital, Rikshospitalet from February 2010 to June 2013. All the patients underwent preoperative echocardiographic evaluation with retrospective speckle-tracking analysis. Primary endpoints were 1- and 2-year mortality beyond 30 days after TAVI. Results: All-cause 1- and 2-year mortality beyond 30 days after TAVI was 12.1 and 19.5%, respectively. Predictors of 1-year mortality beyond 30 days were body mass index [hazard ratio (HR): 0.88, 95% CI: 0.80–0.98, p = 0.018], previous myocardial infarction (HR: 2.69, 95% CI: 1.14–6.32, p = 0.023), and systolic pulmonary artery pressure ≥ 60 mm Hg (HR: 5.93, 95% CI: 1.67–21.1, p = 0.006). Moderate-to-severe mitral regurgitation (HR: 2.93, 95% CI: 1.53–5.63, p = 0.001), estimated glomerular filtration rate (HR: 0.98, 95% CI: 0.96–0.99, p = 0.002), and chronic obstructive pulmonary disease (HR: 1.9, 95% CI: 1.01–3.58, p = 0.046) were predictors of 2-year mortality. Conclusion: Both the clinical and echocardiographic parameters should be considered when evaluating high-risk patients for TAVI, as both are predictive of 1-and 2-year mortality. Our results support the importance of individual risk assessment using a multidisciplinary, multimodal, and individual approach. Article in Journal/Newspaper North Norway Tromsø Frontiers (Publisher) Norway Tromsø Frontiers in Cardiovascular Medicine 8 |
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Cardiology and Cardiovascular Medicine |
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Cardiology and Cardiovascular Medicine Kjønås, Didrik Schirmer, Henrik Aakhus, Svend Eidet, Jo Malm, Siri Aaberge, Lars Busund, Rolf Rösner, Assami Clinical and Echocardiographic Parameters Predicting 1- and 2-Year Mortality After Transcatheter Aortic Valve Implantation |
topic_facet |
Cardiology and Cardiovascular Medicine |
description |
Background: Transcatheter aortic valve implantation (TAVI) has become a standard treatment option for patients with symptomatic aortic stenosis. Elderly high-risk patients treated with TAVI have a high residual mortality due to preexisting comorbidities. Knowledge of factors predicting futility after TAVI is sparse and clinical tools to aid the preoperative evaluation are lacking. The aim of this study was to evaluate if echocardiographic measures, including speckle-tracking analysis, in addition to clinical parameters, could aid in the prediction of mortality beyond 30 days after TAVI. Methods: This prospective observational cohort study included 227 patients treated with TAVI at the University Hospital of North Norway, Tromsø and Oslo University Hospital, Rikshospitalet from February 2010 to June 2013. All the patients underwent preoperative echocardiographic evaluation with retrospective speckle-tracking analysis. Primary endpoints were 1- and 2-year mortality beyond 30 days after TAVI. Results: All-cause 1- and 2-year mortality beyond 30 days after TAVI was 12.1 and 19.5%, respectively. Predictors of 1-year mortality beyond 30 days were body mass index [hazard ratio (HR): 0.88, 95% CI: 0.80–0.98, p = 0.018], previous myocardial infarction (HR: 2.69, 95% CI: 1.14–6.32, p = 0.023), and systolic pulmonary artery pressure ≥ 60 mm Hg (HR: 5.93, 95% CI: 1.67–21.1, p = 0.006). Moderate-to-severe mitral regurgitation (HR: 2.93, 95% CI: 1.53–5.63, p = 0.001), estimated glomerular filtration rate (HR: 0.98, 95% CI: 0.96–0.99, p = 0.002), and chronic obstructive pulmonary disease (HR: 1.9, 95% CI: 1.01–3.58, p = 0.046) were predictors of 2-year mortality. Conclusion: Both the clinical and echocardiographic parameters should be considered when evaluating high-risk patients for TAVI, as both are predictive of 1-and 2-year mortality. Our results support the importance of individual risk assessment using a multidisciplinary, multimodal, and individual approach. |
author2 |
Helse Nord RHF |
format |
Article in Journal/Newspaper |
author |
Kjønås, Didrik Schirmer, Henrik Aakhus, Svend Eidet, Jo Malm, Siri Aaberge, Lars Busund, Rolf Rösner, Assami |
author_facet |
Kjønås, Didrik Schirmer, Henrik Aakhus, Svend Eidet, Jo Malm, Siri Aaberge, Lars Busund, Rolf Rösner, Assami |
author_sort |
Kjønås, Didrik |
title |
Clinical and Echocardiographic Parameters Predicting 1- and 2-Year Mortality After Transcatheter Aortic Valve Implantation |
title_short |
Clinical and Echocardiographic Parameters Predicting 1- and 2-Year Mortality After Transcatheter Aortic Valve Implantation |
title_full |
Clinical and Echocardiographic Parameters Predicting 1- and 2-Year Mortality After Transcatheter Aortic Valve Implantation |
title_fullStr |
Clinical and Echocardiographic Parameters Predicting 1- and 2-Year Mortality After Transcatheter Aortic Valve Implantation |
title_full_unstemmed |
Clinical and Echocardiographic Parameters Predicting 1- and 2-Year Mortality After Transcatheter Aortic Valve Implantation |
title_sort |
clinical and echocardiographic parameters predicting 1- and 2-year mortality after transcatheter aortic valve implantation |
publisher |
Frontiers Media SA |
publishDate |
2021 |
url |
http://dx.doi.org/10.3389/fcvm.2021.739710 https://www.frontiersin.org/articles/10.3389/fcvm.2021.739710/full |
geographic |
Norway Tromsø |
geographic_facet |
Norway Tromsø |
genre |
North Norway Tromsø |
genre_facet |
North Norway Tromsø |
op_source |
Frontiers in Cardiovascular Medicine volume 8 ISSN 2297-055X |
op_rights |
https://creativecommons.org/licenses/by/4.0/ |
op_doi |
https://doi.org/10.3389/fcvm.2021.739710 |
container_title |
Frontiers in Cardiovascular Medicine |
container_volume |
8 |
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1795035280504258560 |