Impact of left ventricular diastolic function and survival in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement

In year 2016, the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI) updated Recommendations for the assessment and grading of diastolic dysfunction (DD). We aimed to assess the applicability of this DD grading method and its association with pr...

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Bibliographic Details
Published in:PloS one 2018-05, Vol.13 (5), p.e0196031-e0196031
Main Authors: Sato, Kimi, Harb, Serge, Kumar, Arnav, Kapadia, Samir R, Mick, Stephanie, Krishnaswamy, Amar, Desai, Milind Y, Griffin, Brian P, Rodriguez, L Leonardo, Tuzcu, E Murat, Svensson, Lars G, Popović, Zoran B
Format: Article
Language:English
Subjects:
Aorta
Aortic stenosis
Aortic valve
Aortic valve stenosis
Biology and Life Sciences
Cardiac arrhythmia
Care and treatment
Echocardiography
Evaluation
Femur
Grading
Hazards
Heart
Heart valve replacement
Hemodynamics
Implantation
Medical prognosis
Medicine and Health Sciences
Patient outcomes
Patients
Physical Sciences
Prognosis
Research and Analysis Methods
Statistical models
Stenosis
Survival
Ventricle
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Summary:In year 2016, the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI) updated Recommendations for the assessment and grading of diastolic dysfunction (DD). We aimed to assess the applicability of this DD grading method and its association with prognosis in patients with severe aortic stenosis (AS) who underwent transcatheter aortic valve implantation (TAVI). We retrospectively identified 237 consecutive patients with severe AS who underwent trans-femoral TAVI. Baseline transthoracic echocardiography was evaluated to assess pre- and post-TAVI diastolic function according to the current ASE/EACVI Recommendations. Prior to TAVI, 41 (17%) patients were diagnosed as having grade I DD, 111 (47%) patients had grade II DD, 80 (34%) had grade III DD. DD grade after TAVI decreased (p < 0.001) with 75 patients (32%) reclassified to a lower DD grade. During the median follow-up of 1,320 days, 136 (57%) patients died. In univariable Cox proportional hazards model analysis, neither pre- nor post-TAVI DD grade were associated with prognosis. However, patients with grade III DD detected before TAVI and AR≥ 2 after TAVI had poorer survival (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0196031