Medium and Long-term Prognosis of Transcatheter Aortic Valve Implantation from the Perspective of Left Ventricular Diastolic Function

Overview

Journal Cardiol J

Specialty Cardiology & Vascular Diseases

Date 2018 Mar 24

PMID 29570210

Citations 3

Authors

Satoru Kayama

Shungo Aratake

Shegehito Sawamura

Yusuke Watanabe

Ken Kozuma

Affiliations

Soon will be listed here.

Abstract

Background: The effects of left ventricular (LV) diastolic function are well known in cardiac surgery, but unclear in transcatheter aortic valve implantation (TAVI). The objective of this study was to exam- ine the association of preoperative LV diastolic function with medium to long-term outcomes of TAVI.

Methods: Eighty patients who underwent TAVI were classified into grades I, II and III based on pre- operative LV diastolic function. Findings related to cardiovascular outcomes after TAVI were extracted retrospectively from clinical and echocardiographic data and relationships with diastolic function were examined.

Results: The average follow-up was 529 days (interquartile range {IQR] 358-741 days). Cardiovascu- lar events occurred in 17 cases, including 6 deaths, and were significantly associated with Euro II score (p = 0.043), albumin level (p = 0.026), coronary artery disease (CAD) (p = 0.017), and diastolic func- tion (p < 0.001). The 360-day event-free rates were 89.5%, 89.5% and 37.5% for grades I, II and III (p = 0.00013). Median event-free survival (EFS) in grade III cases was 180 days. In a Cox propor- tional hazard model, LV diastolic dysfunction (hazard ratio [HR] 3.99, 95% confidence interval [CI] 1.35-11.80, p = 0.012) and low albumin (HR 4.73, 95% CI 1.42-15.80, p = 0.012) were significant independent predictors of reduced EFS.

Conclusions: Medium to long-term outcomes of TAVI were poorer in patients with deteriorated LV diastolic function, and outcomes in grade III cases were significantly worse than those in grade I and II cases. Preoperative LV diastolic function may be useful in prediction of outcomes after TAVI.

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