Prognostic impact of invasive haemodynamic measurements in combination with clinical and echocardiographic characteristics on two-year clinical outcomes of patients undergoing transcatheter aortic valve implantation.

Franzone, Anna; O'Sullivan, Crochan J; Stortecky, Stefan; Heg, Dik; Lanz, Jonas; Vollenbroich, René; Praz, Fabien; Piccolo, Raffaele; Asami, Masahiko; Roost, Eva; Räber, Lorenz; Valgimigli, Marco; Windecker, Stephan; Pilgrim, Thomas (2017). Prognostic impact of invasive haemodynamic measurements in combination with clinical and echocardiographic characteristics on two-year clinical outcomes of patients undergoing transcatheter aortic valve implantation. EuroIntervention, 12(18), e2186-e2193. Europa Digital & Publishing 10.4244/EIJ-D-16-00790

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AIMS The aim of the study was to evaluate the prognostic utility of right heart catheterisation (RHC)-derived measures among patients undergoing transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS Data of 469 patients included in the Bern TAVI Registry between August 2007 and December 2012 and undergoing preoperative RHC were analysed. The relationship between haemodynamic parameters and survival was evaluated with Cox proportional hazards models. At two-year follow-up, 118 patients had died (25.1%). At multivariable analysis, diabetes (hazard ratio [HR] 1.95, 95% confidence interval [CI]: 1.28-2.96, p=0.001), transapical access (HR 1.66, 95% CI: 1.07-2.56, p=0.02), and moderate or severe mitral regurgitation (HR 1.55, 95% CI: 1.00-2.39, p=0.04) were independent predictors of two-year mortality, whereas no correlation between RHC-derived measures and mortality was found. Furthermore, the addition of haemodynamic variables did not significantly improve the prognostic power of a model incorporating clinical and echocardiographic data (Harrell's C-index: 0.667, 95% CI: 0.615-0.719 vs. 0.662, 95% CI: 0.612-0.713, p=0.47). CONCLUSIONS On the basis of a comprehensive clinical and echocardiographic evaluation, RHC performed prior to TAVI does not add incremental prognostic value.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Franzone, Anna; O'Sullivan, Crochan John; Stortecky, Stefan; Heg, Dierik Hans; Lanz, Jonas; Vollenbroich, René; Praz, Fabien; Piccolo, Raffaele; Asami, Masahiko; Roost, Eva; Räber, Lorenz; Valgimigli, Marco; Windecker, Stephan and Pilgrim, Thomas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1774-024X

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

05 Sep 2017 12:44

Last Modified:

12 Oct 2017 16:26

Publisher DOI:

10.4244/EIJ-D-16-00790

PubMed ID:

28117283

BORIS DOI:

10.7892/boris.102372

URI:

https://boris.unibe.ch/id/eprint/102372

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