Prognostic Relevance of Left Ventricular Myocardial Performance After Transcatheter Aortic Valve Replacement.

Asami, Masahiko; Pilgrim, Thomas; Lanz, Jonas; Heg, Dik; Franzone, Anna; Piccolo, Raffaele; Langhammer, Bettina; Praz, Fabien; Räber, Lorenz; Valgimigli, Marco; Roost, Eva; Windecker, Stephan; Stortecky, Stefan (2019). Prognostic Relevance of Left Ventricular Myocardial Performance After Transcatheter Aortic Valve Replacement. Circulation: Cardiovascular interventions, 12(1), e006612. Lippincott Williams & Wilkins 10.1161/CIRCINTERVENTIONS.118.006612

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BACKGROUND The left-ventricular myocardial performance index Tei is an echocardiographic parameter that incorporates the information of systolic and diastolic time intervals. While the prognostic value of selected systolic and diastolic parameters is well established after transcatheter aortic valve replacement, the role of Tei has not been evaluated in this setting. METHODS AND RESULTS Between August 2007 and December 2015, consecutive patients with symptomatic, severe aortic stenosis and transthoracic echocardiography pre- and post-transcatheter aortic valve replacement were considered eligible for this analysis. The primary end point was all-cause mortality at 1 year after transcatheter aortic valve replacement. Of 824 patients with echocardiographic images to calculate Tei, pre-Tei was normal (<0.45) in 639 and high (≥0.45) in 185, whereas post-Tei was normal in 602 and high in 120, respectively. After adjustment for confounding factors, high pre-Tei was associated with an increased risk of all-cause mortality at 30 days (adjusted hazard ratio [HR] 3.62; 95% CI, 1.89-6.91) and 1 year (HR 2.56; 95% CI, 1.78-3.69). Similarly, post-Tei was associated with an increased risk of mortality between 30 days and 1-year follow-up (HR 6.70; 95% CI, 4.22-10.63). At multivariable analysis Tei emerged as an independent predictor of early (pre-Tei index per 0.1-HR 1.40; 95% CI, 1.23-1.60) and late mortality (post-Tei index per 0.1-HR 1.40; 95% CI, 1.31-1.50), respectively. CONCLUSIONS The left-ventricular myocardial performance index Tei is associated with impaired clinical outcomes during short- and longer-term follow-up after transcatheter aortic valve replacement. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov . Unique identifier: NCT01368250.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Asami, Masahiko; Pilgrim, Thomas; Lanz, Jonas; Heg, Dierik Hans; Franzone, Anna; Piccolo, Raffaele; Langhammer, Bettina; Praz, Fabien; Räber, Lorenz; Valgimigli, Marco; Roost, Eva; Windecker, Stephan and Stortecky, Stefan

Subjects:

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

ISSN:

1941-7632

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

23 Jan 2019 11:37

Last Modified:

05 Feb 2019 10:47

Publisher DOI:

10.1161/CIRCINTERVENTIONS.118.006612

PubMed ID:

30626203

Uncontrolled Keywords:

aortic valve stenosis echocardiography human prognosis transcatheter aortic valve replacement

BORIS DOI:

10.7892/boris.124533

URI:

https://boris.unibe.ch/id/eprint/124533

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