Prognostic impact of cardiac damage staging classification in each aortic stenosis subtype undergoing TAVI.


Journal

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
ISSN: 1969-6213
Titre abrégé: EuroIntervention
Pays: France
ID NLM: 101251040

Informations de publication

Date de publication:
04 Dec 2023
Historique:
pmc-release: 04 12 2024
medline: 6 12 2023
pubmed: 10 11 2023
entrez: 10 11 2023
Statut: epublish

Résumé

The prognostic value of cardiac damage staging classifications across the haemodynamic spectrum of severe aortic stenosis (AS) remains unknown. We aimed to investigate the prognostic impact of cardiac damage staging classifications in patients with high-gradient AS (HG-AS) and low-gradient AS (LG-AS) undergoing transcatheter aortic valve implantation (TAVI). In a prospective TAVI registry, five-year mortality was evaluated for early stages of cardiac damage (stage 0, 1, or 2) and advanced stages of cardiac damage (stage 3 or 4) in patients with HG-AS, classical low-flow (LF) LG-AS, LF LG-AS with preserved ejection fraction (pEF), and normal-flow (NF) LG-AS. Among 2,090 patients undergoing TAVI, 1,045 patients had HG-AS, 337 patients had classical LF LG-AS, 394 patients had LF LG-AS with pEF, and 314 patients had NF LG-AS. The majority of patients with classical LF LG-AS exhibited advanced cardiac damage (73.6%), followed by LF LG-AS with pEF (55.6%), NF LG-AS (51.6%), and HG-AS (50.6%). Patients with advanced stage cardiac damage had significantly higher mortality after TAVI than those with early stage cardiac damage in all subtypes of AS (adjusted hazard ratio [HR Cardiac damage staging classifications stratified mortality after TAVI irrespective of AS subtype.

Sections du résumé

BACKGROUND BACKGROUND
The prognostic value of cardiac damage staging classifications across the haemodynamic spectrum of severe aortic stenosis (AS) remains unknown.
AIMS OBJECTIVE
We aimed to investigate the prognostic impact of cardiac damage staging classifications in patients with high-gradient AS (HG-AS) and low-gradient AS (LG-AS) undergoing transcatheter aortic valve implantation (TAVI).
METHODS METHODS
In a prospective TAVI registry, five-year mortality was evaluated for early stages of cardiac damage (stage 0, 1, or 2) and advanced stages of cardiac damage (stage 3 or 4) in patients with HG-AS, classical low-flow (LF) LG-AS, LF LG-AS with preserved ejection fraction (pEF), and normal-flow (NF) LG-AS.
RESULTS RESULTS
Among 2,090 patients undergoing TAVI, 1,045 patients had HG-AS, 337 patients had classical LF LG-AS, 394 patients had LF LG-AS with pEF, and 314 patients had NF LG-AS. The majority of patients with classical LF LG-AS exhibited advanced cardiac damage (73.6%), followed by LF LG-AS with pEF (55.6%), NF LG-AS (51.6%), and HG-AS (50.6%). Patients with advanced stage cardiac damage had significantly higher mortality after TAVI than those with early stage cardiac damage in all subtypes of AS (adjusted hazard ratio [HR
CONCLUSIONS CONCLUSIONS
Cardiac damage staging classifications stratified mortality after TAVI irrespective of AS subtype.

Identifiants

pubmed: 37946532
pii: EIJ-D-23-00590
doi: 10.4244/EIJ-D-23-00590
pmc: PMC10687648
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e865-e874

Auteurs

Masaaki Nakase (M)

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

Taishi Okuno (T)

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

Daijiro Tomii (D)

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

Bashir Alaour (B)

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

Fabien Praz (F)

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

Stefan Stortecky (S)

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

Jonas Lanz (J)

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

David Reineke (D)

Department of Cardiovascular Surgery, Inselspital, University of Bern, Bern, Switzerland.

Stephan Windecker (S)

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

Thomas Pilgrim (T)

Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

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Classifications MeSH