Prognostic implication of right ventricular dysfunction and tricuspid regurgitation following transcatheter aortic valve replacement.
Aortic Valve
/ diagnostic imaging
Aortic Valve Stenosis
/ diagnostic imaging
Humans
Prognosis
Retrospective Studies
Risk Factors
Severity of Illness Index
Transcatheter Aortic Valve Replacement
/ adverse effects
Treatment Outcome
Tricuspid Valve Insufficiency
/ diagnostic imaging
Ventricular Dysfunction, Right
/ diagnostic imaging
ITTE
TTE/TEE
aortic valve disease (AVDP)
imaging
percutaneous intervention
transcatheter valve implantation (TVI)
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
revised:
03
02
2021
received:
06
11
2020
accepted:
24
02
2021
pubmed:
9
3
2021
medline:
15
12
2021
entrez:
8
3
2021
Statut:
ppublish
Résumé
Right ventricular (RV) dysfunction and tricuspid regurgitation (TR) are associated with adverse outcomes in severe aortic stenosis (AS) patients. Our aim was to evaluate the association between ≥moderate TR and RV dysfunction on long-term mortality following transcatheter aortic valve replacement (TAVR). A retrospective analysis of the Israeli multicenter TAVR registry among 4,344 consecutive patients, with all-cause mortality as the main outcome measure. Echocardiographic assessment of TR grade and RV dysfunction was available for 3,733 and 1,850 patients, of whom ≥moderate TR and RV dysfunction was noted for 478(13%) and 78(4%), respectively. The mean follow-up time was 2.9 ± 2.3 years. In univariate models, ≥Moderate TR and ≥moderate RV dysfunction were associated with increased long-term mortality (HR 1.45, 95% CI 1.24-1.69, p < .001 and HR 1.73, 95% CI 1.21-2.47, p = 0.003, respectively). These finding did not remained significant after adjusting to echocardiographic parameters. A subset of patients with no improvement in RV function had the highest long-term mortality risk (HR 3.3, 95% CI 1.95-5.7, p < .001). When adjusted to multiple echocardiographic characteristics baseline ≥Moderate TR and ≥moderate RV dysfunction were not associated with long-term mortality following TAVR. Persistent RV dysfunction following TAVR was associated with the highest risk for mortality.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
E758-E767Informations de copyright
© 2021 Wiley Periodicals LLC.
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