Tomii, Daijiro; Okuno, Taishi; Demirel, Caglayan; Praz, Fabien Daniel; Lanz, Jonas; Stortecky, Stefan; Windecker, Stephan; Pilgrim, Thomas (2022). Impact of first-phase ejection fraction on clinical outcomes in patients undergoing transcatheter aortic valve implantation. Cardiovascular revascularization medicine, 42, pp. 55-61. Elsevier 10.1016/j.carrev.2022.02.023
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BACKGROUND
First-phase left ventricular ejection fraction (LVEF1) is an early marker of left ventricular remodeling. Reduced LVEF1 has been associated with adverse prognosis in patients with aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF). It remains to be determined, whether reduced LVEF1 differentiates clinical outcomes after aortic valve replacement.
OBJECTIVES
We investigated the impact of LVEF1 on clinical outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) for symptomatic severe AS with preserved LVEF (≥ 50%).
METHODS
In the prospective Bern TAVI registry, we retrospectively categorized patients according to LVEF1 as assessed by transthoracic echocardiography. Clinical outcomes of interest were all-cause mortality and residual heart failure symptoms (New York Heart Association (NYHA) functional class III or IV) at 1 year after TAVI.
RESULTS
A total of 644 patients undergoing TAVI between January 2014 and December 2019 were included in the present analysis. Patients with low LVEF1 had a lower LVEF (62.0 ± 6.89% vs. 64.3 ± 7.82%, P < 0.001) and a higher left ventricular mass index (129.3 ± 39.1 g/m2 vs. 121.5 ± 38.0 g/m2; P = 0.027) compared to patients with high LVEF1. At 1 year, the incidence of all-cause/cardiovascular death, and NYHA III or IV were comparable between patients with low and high LVEF1 (8.3% vs. 9.2%; P = 0.773, 3.9% vs. 6.0%; P = 0.276, 12.9% vs. 12.2%; P = 0.892, respectively).
CONCLUSIONS
Reduced LVEF1 was not associated with adverse clinical outcomes following TAVI in patients with symptomatic severe AS with preserved LVEF.
CLINICAL TRIAL REGISTRATION
https://www.
CLINICALTRIALS
gov. NCT01368250.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Tomii, Daijiro, Okuno, Taishi, Demirel, Caglayan, Praz, Fabien Daniel, Lanz, Jonas, Stortecky, Stefan, Windecker, Stephan, Pilgrim, Thomas |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1878-0938 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
15 Mar 2022 12:08 |
Last Modified: |
05 Dec 2022 16:15 |
Publisher DOI: |
10.1016/j.carrev.2022.02.023 |
PubMed ID: |
35283064 |
Uncontrolled Keywords: |
Aortic stenosis First-phase ejection fraction Left ventricular ejection fraction Left ventricular remodeling Transcatheter aortic valve replacement |
BORIS DOI: |
10.48350/167403 |
URI: |
https://boris.unibe.ch/id/eprint/167403 |