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

Nakase, Masaaki; Okuno, Taishi; Tomii, Daijiro; Alaour, Bashir; Praz, Fabien; Stortecky, Stefan; Lanz, Jonas; Reineke, David; Windecker, Stephan; Pilgrim, Thomas (2023). Prognostic impact of cardiac damage staging classification in each aortic stenosis subtype undergoing TAVI. EuroIntervention, 19(10), e865-e874. Europa Digital & Publishing 10.4244/EIJ-D-23-00590

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BACKGROUND

The prognostic value of cardiac damage staging classifications across the haemodynamic spectrum of severe aortic stenosis (AS) remains unknown.

AIMS

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

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

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 [HRadjusted] 1.66, 95% confidence interval [CI]: 1.34-2.06 for HG-AS; HRadjusted 1.49, 95% CI: 1.02-2.16 for classical LF LG-AS; HRadjusted 1.69, 95% CI: 1.22-2.35 for LF LG-AS with pEF; and HRadjusted 1.52, 95% CI: 1.04-2.32 for NF LG-AS).

CONCLUSIONS

Cardiac damage staging classifications stratified mortality after TAVI irrespective of AS subtype.

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 Heart Surgery

UniBE Contributor:

Okuno, Taishi, Tomii, Daijiro, Praz, Fabien Daniel, Stortecky, Stefan, Lanz, Jonas, Reineke, David Christian, Windecker, Stephan, Pilgrim, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1969-6213

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Pubmed Import

Date Deposited:

14 Nov 2023 12:51

Last Modified:

27 Feb 2024 14:27

Publisher DOI:

10.4244/EIJ-D-23-00590

PubMed ID:

37946532

URI:

https://boris.unibe.ch/id/eprint/188785

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