Association Between Diastolic Dysfunction and Health Status Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement

被引:8
作者
Malik, Ali O. [1 ,2 ]
Omer, Mohamed [1 ,2 ]
Pflederer, Mathew C. [1 ,2 ]
Almomani, Ahmed [1 ,2 ]
Gosch, Kensey L. [2 ]
Jones, Philip G. [2 ]
Peri-Okonny, Poghni A. [1 ,2 ]
Al Badarin, Firas [1 ,2 ]
Brandt, Hunter A. [2 ]
Arnold, Suzanne V. [1 ,2 ]
Main, Michael L. [1 ,2 ]
Cohen, David J. [1 ,2 ]
Spertus, John A. [1 ,2 ]
Chhatriwalla, Adnan K. [1 ,2 ]
机构
[1] Univ Missouri Kansas City, Kansas City, MO USA
[2] St Lukes Mid Amer Heart Inst, Kansas City, MO USA
关键词
health status; left ventricular diastolic dysfunction; transcatheter aortic valve replacement; CITY CARDIOMYOPATHY QUESTIONNAIRE; VENTRICULAR HYPERTROPHY; HEART-FAILURE;
D O I
10.1016/j.jcin.2019.08.036
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES The aim of this study was to assess the association of baseline left ventricular diastolic dysfunction (LVDD) with health status outcomes of patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND Although LVDD in patients with aortic stenosis is associated with higher mortality after TAVR, it is unknown if it is also associated with health status recovery. METHODS In a cohort of 304 patients with interpretable echocardiograms, undergoing TAVR, LVDD was categorized at baseline as absent (grade 0), mild (grade 1), moderate (grade 2), or severe (grade 3). Disease-specific health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OS) at baseline and at 1-month and 12-month follow-up. Association of baseline LVDD with health status at baseline and follow-up after TAVR was assessed using a linear trend test, and association with health status recovery (change in KCCQ-OS) was examined using a linear mixed model adjusting for baseline KCCQ-OS. RESULTS Twenty-four (7.9%), 54 (17.8%), 186 (61.2%), and 40 (13.2%) patients had LVDD grades of 0, 1, 2, and 3, respectively. Baseline KCCQ-OS was 61.3 +/- 22.7, 51.0 +/- 26.1, 44.7 +/- 25.7, and 44.4 +/- 21.9 (p = 0.004) in patients with LVDD grades of 0, 1,2 and 3. At 1 and 12 months after TAVR, LVDD was not associated with KCCQ-OS. Recovery in KCCQ-OS after TAVR was substantial and similar in patients across all severities of LVDD. CONCLUSIONS Although LVDD is associated with health status prior to TAVR, patients across all severities of LVDD have similar recovery in health status after TAVR. (C) 2019 by the American College of Cardiology Foundation.
引用
收藏
页码:2476 / 2484
页数:9
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