Prognostic Value of Electrocardiographic Left Ventricular Hypertrophy After Transcatheter Aortic Valve Implantation: Insights from the OCEAN-TAVI Registry

被引:4
作者
Koga, Masashi [1 ]
Izumo, Masaki [1 ]
Yoneyama, Kihei [1 ]
Akashi, Yoshihiro J. [1 ]
Yashima, Fumiaki [2 ]
Tada, Norio [3 ]
Yamawaki, Masahiro [4 ]
Shirai, Shinichi [5 ]
Naganuma, Toru [6 ]
Yamanaka, Futoshi [7 ]
Ueno, Hiroshi [8 ]
Tabata, Minoru [9 ]
Mizutani, Kazuki [10 ]
Takagi, Kensuke [11 ]
Watanabe, Yusuke [12 ]
Yamamoto, Masanori [13 ,14 ]
Hayashida, Kentaro [15 ]
机构
[1] St Marianna Univ, Div Cardiol, Sch Med, Kawasaki, Japan
[2] Saiseikai Utsunomiya Hosp, Dept Cardiol, Utsunomiya, Japan
[3] Sendai Kosei Hosp, Dept Cardiol, Sendai, Japan
[4] Saiseikai Yokohama City Eastern Hosp, Dept Cardiol, Yokohama, Japan
[5] Kokura Mem Hosp, Dept Cardiovasc Med cine, Kitakyushu, Japan
[6] New Tokyo Hosp, Dept Car diol, Matsudo, Japan
[7] Shonan Kamakura Gen Hosp, Dept Cardiol, Kamakura, Japan
[8] Toyama Univ Hosp, Dept Cardiovasc Med, Toyama, Japan
[9] Tokyo Bay Urayasu Ichikawa Med Ctr, Dept Cardiovasc Surg, Urayasu, Japan
[10] Kindai Univ, Fac Med, Dept Cardiol, Osaka, Japan
[11] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, Osaka, Japan
[12] Teikyo Univ, Dept Cardiol, Sch Med, Tokyo, Japan
[13] Toyohashi Heart Ctr, Dept Cardiol, Toyohashi, Japan
[14] Nagoya Heart Ctr, Dept Cardiol, Nagoya, Japan
[15] Keio Univ, Dept Cardiol, Sch Med, Tokyo, Japan
关键词
transcatheter aortic valve implantation; electrocardiogram; left ventricular hypertro-phy; prognosis; STENOSIS; REPLACEMENT; RECOMMENDATIONS; ASSOCIATION; PREVALENCE; MORTALITY; DIAGNOSIS; OUTCOMES; SOCIETY; DEATH;
D O I
10.1016/j.amjcard.2023.07.101
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Electrocardiogram (ECG) left ventricular hypertrophy (LVH) is associated with the prog-nosis of patients with aortic stenosis. However, the impact of the presence or absence of ECG-LVH on the clinical outcomes after transcatheter aortic valve implantation (TAVI) is limited. This study aimed to assess the prognostic value of ECG-LVH among patients with aortic stenosis treated by TAVI. A total of 1,667 patients who underwent TAVI were prospectively enrolled into the OCEAN-TAVI (Optimized CathEter vAlvular iNterven-tion-Transcatheter Aortic Valve Implantation) registry. A total of 1,446 patients (mean age 84 years; 29.9% men) were analyzed. The Sokolow-Lyon index was used to determine the presence of ECG-LVH. LVH was also assessed using transthoracic echocardiography (TTE). We investigated the association between ECG-LVH and all-cause and cardiovascu-lar mortality. This study identified ECG-LVH and TTE-LVH in 743 (51.5%) and 1,242 patients (86.0%), respectively. The Kaplan-Meier analysis revealed that all-cause mortal-ity was significantly higher among patients without ECG-LVH than among those with ECG-LVH (log-rank p <0.001). In the multivariable analysis, the absence of ECG-LVH was independently associated with all-cause mortality (hazard ratio 1.98, 95% confidence interval 1.39 to 2.82, p <0.001), regardless of the presence or absence of TTE-LVH. Fur-thermore, the presence of TTE-LVH with the absence of ECG-LVH was observed in 575 patients (40%), which was associated with cardiovascular mortality (hazard ratio 2.84, 95% confidence interval 1.56 to 5.17, p <0.001). In conclusion, the absence of ECG-LVH was independently associated with an increased risk of all-cause mortality after TAVI. Risk stratification using both ECG-LVH and TTE-LVH is a useful predictor of adverse clinical outcomes after TAVI. & COPY; 2023 Elsevier Inc. All rights reserved. (Am J Cardiol 2023;204:130-139)
引用
收藏
页码:130 / 139
页数:10
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