Aortic Stenosis and the Evolution of Cardiac Damage after Transcatheter Aortic Valve Replacement

被引:0
作者
Islas, Fabian [1 ,2 ]
O'Neill-Gonzalez, Patrick [1 ]
Jimenez-Quevedo, Pilar [1 ]
Nombela-Franco, Luis [1 ]
Gil-Abizanda, Sandra [1 ]
Mahia-Casado, Patricia [1 ]
Rivadeneira-Ruiz, Maria [1 ]
Pozo-Osinalde, Eduardo [1 ]
Carbone, Andreina [3 ]
Olmos, Carmen [1 ]
机构
[1] Hosp Clin San Carlos IDISSC, Hosp Clin San Carlos, Inst Cardiovasc, Inst Invest Sanitaria, Madrid 28040, Spain
[2] Hosp Univ Nuestra Senora del Prado, Unidad Imagen Cardiaca, Talavera De La Reina 45600, Spain
[3] Univ Campania Luigi Vanvitelli, Cardiol Unit, I-81100 Naples, Italy
关键词
aortic stenosis; TAVR; cardiac damage staging; CHRONIC KIDNEY-DISEASE; IN-HOSPITAL OUTCOMES; IMPACT; REGURGITATION; ASSOCIATION;
D O I
10.3390/jcm13123539
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background/Objectives: Severe aortic stenosis (AS) is the most frequent valvular heart disease. Models for stratifying cardiac damage associated with aortic stenosis have been developed to predict outcomes following valve replacement. However, evidence regarding morphological and functional evolution, as well as potential changes in the degree of cardiac damage, is limited. We aim to provide information on the evolution of cardiac morphology and the function of patients undergoing transcatheter aortic valve replacement (TAVR) who have been classified using a cardiac damage staging system. Methods: In total, 496 patients were included in the analysis, and were classified into four stages based on the extent of cardiac damage as follows: Stage 0, no cardiac damage: left ventricle global longitudinal strain (LV-GLS) < -17%; right ventricular-arterial coupling (RVAc) >= 0.35), and absence of significant mitral regurgitation (MR). Stage 1, left-sided subclinical damage: LV-GLS >= -17%. Stage 2, left-sided damage: significant MR. Stage 3, right-sided damage: RVAc < 0.35. Results: The mean age was 82.1 +/- 5.9 years, and 53.0% were female. In total, 24.5% of patients met the criteria for Stage 0, and Stage 1 included 42.8% of patients, Stage 2 included 16.5%, and Stage 3 comprised 16.2% of patients. Mortality was 8.4% for stage 0, 17.4% for stage 1, 25.6% for stage 2, and 28.6% for stage 3 patients (p = 0.004). Diabetes mellitus (DM) (p = 0.047) and chronic kidney disease (CKD) (p = 0.024) were the only clinical predictors of no change or worsening in the stage of cardiac damage. Regarding echocardiographic variables, concomitant tricuspid, and mitral regurgitation, >= 2 were both significantly associated with no change or worsening, also (p < 0.001). Conclusions: Cardiac damage that is secondary to severe aortic stenosis has morphological and functional repercussions that, even after valve replacement, persist and might worsen the prognosis.
引用
收藏
页数:11
相关论文
共 23 条
[1]   Clinical Impact of Diabetes Mellitus on Outcomes After Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry [J].
Abramowitz, Yigal ;
Vemulapalli, Sreekanth ;
Chakravarty, Tarun ;
Li, Zhuokai ;
Kapadia, Samir ;
Holmes, David ;
Matsouaka, Roland A. ;
Wang, Alice ;
Cheng, Wen ;
Forrester, James S. ;
Smalling, Richard ;
Thourani, Vinod ;
Mack, Michael ;
Leon, Martin ;
Makkar, Raj R. .
CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2017, 10 (11)
[2]   Advanced chronic kidney disease in patients undergoing transcatheter aortic valve implantation: insights on clinical outcomes and prognostic markers from a large cohort of patients [J].
Allende, Ricardo ;
Webb, John G. ;
Munoz-Garcia, Antonio J. ;
de Jaegere, Peter ;
Tamburino, Corrado ;
Dager, Antonio E. ;
Cheema, Asim ;
Serra, Vicenc ;
Amat-Santos, Ignacio ;
Velianou, James L. ;
Barbanti, Marco ;
Dvir, Danny ;
Alonso-Briales, Juan H. ;
Nuis, Rutger-Jan ;
Faqiri, Elhamula ;
Imme, Sebastiano ;
Miguel Benitez, Luis ;
Maria Cucalon, Angela ;
Al Lawati, Hatim ;
Garcia del Blanco, Bruno ;
Lopez, Javier ;
Natarajan, Madhu K. ;
DeLarochelliere, Robert ;
Urena, Marina ;
Ribeiro, Henrique B. ;
Dumont, Eric ;
Nombela-Franco, Luis ;
Rodes-Cabau, Josep .
EUROPEAN HEART JOURNAL, 2014, 35 (38) :2685-2696
[3]   Pulmonary Hypertension in Patients With Severe Aortic Stenosis: Prognostic Impact After Transcatheter Aortic Valve Replacement Pulmonary Hypertension in Patients Undergoing TAVR [J].
Alushi, Brunilda ;
Beckhoff, Frederik ;
Leistner, David ;
Franz, Marcus ;
Reinthaler, Markus ;
Staehli, Barbara E. ;
Morguet, Andreas ;
Figulla, Hans R. ;
Doenst, Torsten ;
Maisano, Francesco ;
Falk, Volkmar ;
Landmesser, Uif ;
Lauten, Alexander .
JACC-CARDIOVASCULAR IMAGING, 2019, 12 (04) :591-601
[4]  
Amat-Santos IJ, 2018, REV ESP CARDIOL, V71, P357, DOI [10.1016/j.rec.2017.08.019, 10.1016/j.recesp.2017.08.013]
[5]   Impact of Diabetes Mellitus and Hemoglobin A1C on Outcome After Transcatheter Aortic Valve Implantation [J].
Chorin, Ehud ;
Finkelstein, Ariel ;
Banai, Shmuel ;
Aviram, Galit ;
Barkagan, Michael ;
Barak, Leehee ;
Keren, Gad ;
Steinvil, Arie .
AMERICAN JOURNAL OF CARDIOLOGY, 2015, 116 (12) :1898-1903
[6]   The modern epidemiology of heart valve disease [J].
Coffey, Sean ;
Cairns, Benjamin J. ;
Iung, Bernard .
HEART, 2016, 102 (01) :75-U5
[7]   Impact of tricuspid regurgitation and right ventricular dysfunction on outcomes after transcatheter aortic valve replacement: A systematic review and meta-analysis [J].
Fan, Jiaqi ;
Liu, Xianbao ;
Yu, Lei ;
Sun, Yinghao ;
Jaiswal, Sanjay ;
Zhu, Qifeng ;
Chen, Han ;
He, Yuxin ;
Wang, Lihan ;
Ren, Kaida ;
Wang, Jian'an .
CLINICAL CARDIOLOGY, 2019, 42 (01) :206-212
[8]   Evolution and Prognostic Impact of Cardiac Damage After Aortic Valve Replacement [J].
Genereux, Philippe ;
Pibarot, Philippe ;
Redfors, Bjorn ;
Bax, Jeroen J. ;
Zhao, Yanglu ;
Makkar, Raj R. ;
Kapadia, Samir ;
Thourani, Vinod H. ;
Mack, Michael J. ;
Nazif, Tamim M. ;
Lindman, Brian R. ;
Babaliaros, Vasilis ;
Vincent, Flavien ;
Russo, Mark ;
McCabe, James M. ;
Gillam, Linda D. ;
Alu, Maria C. ;
Hahn, Rebecca T. ;
Webb, John G. ;
Leon, Martin B. ;
Cohen, David J. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2022, 80 (08) :783-800
[9]   Staging classification of aortic stenosis based on the extent of cardiac damage [J].
Genereux, Philippe ;
Pibarot, Philippe ;
Redfors, Bjorn ;
Mack, Michael J. ;
Makkar, Raj R. ;
Jaber, Wael A. ;
Svensson, Lars G. ;
Kapadia, Samir ;
Tuzcu, E. Murat ;
Thourani, Vinod H. ;
Babaliaros, Vasilis ;
Herrmann, Howard C. ;
Szeto, Wilson Y. ;
Cohen, David J. ;
Lindman, Brian R. ;
McAndrew, Thomas ;
Alu, Maria C. ;
Douglas, Pamela S. ;
Hahn, Rebecca T. ;
Kodali, Susheel K. ;
Smith, Craig R. ;
Miller, D. Craig ;
Webb, John G. ;
Leon, Martin B. .
EUROPEAN HEART JOURNAL, 2017, 38 (45) :3351-+
[10]  
Gracia E, 2020, J INVASIVE CARDIOL, V32, P25