Impact of first-phase ejection fraction on clinical outcomes in patients undergoing transcatheter aortic valve implantation.

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

Preview

Text 1-s2.0-S1553838922001075-main.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview

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.

Interest & Impact

Downloads

51 since deposited on 15 Mar 2022
45 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item