Small Left Ventricle and Clinical Outcomes After Transcatheter Aortic Valve Replacement

被引：7

作者：

Saito, Tetsuya ^{[1
]}

Inohara, Taku ^{[1
]}

Yoshijima, Nobuhiro ^{[1
]}

Yashima, Fumiaki ^{[2
]}

Tsuruta, Hikaru ^{[1
]}

Shimizu, Hideyuki ^{[3
]}

Fukuda, Keiichi ^{[1
]}

Naganuma, Toru ^{[4
]}

Mizutani, Kazuki ^{[5
]}

Yamawaki, Masahiro ^{[6
]}

Tada, Norio ^{[7
]}

Yamanaka, Futoshi ^{[8
]}

Shirai, Shinichi ^{[9
]}

Tabata, Minoru ^{[10
]}

Ueno, Hiroshi ^{[11
]}

Takagi, Kensuke ^{[12
]}

Watanabe, Yusuke ^{[13
]}

Yamamoto, Masanori ^{[14
,15
]}

Hayashida, Kentaro ^{[1
]}

机构：

[1] Keio Univ, Dept Cardiol, Sch Med, Tokyo, Japan

[2] Saiseikai Utsunomiya Hosp, Dept Cardiol, Utsunomiya, Tochigi, Japan

[3] Keio Univ, Dept Cardiovasc Surg, Sch Med, Tokyo, Japan

[4] New Tokyo Hosp, Dept Cardiol, Matsudo, Chiba, Japan

[5] Osaka City Gen Hosp, Dept Cardiol, Osaka, Japan

[6] Saiseikai Yokohama City Eastern Hosp, Dept Cardiol, Yokohama, Kanagawa, Japan

[7] Sendai Kousei Hosp, Dept Cardiol, Sendai, Miyagi, Japan

[8] Shonan Kamakura Gen Hosp, Dept Cardiol, Kamakura, Kanagawa, Japan

[9] Kokura Mem Hosp, Dept Cardiol, Kokura, Japan

[10] Tokyo Bay Urayasu Ichikawa Med Ctr, Dept Cardiovasc Surg, Chiba, Japan

[11] Toyama Univ Hosp, Dept Cardiol, Toyama, Japan

[12] Ogaki Municipal Hosp, Dept Cardiol, Gifu, Japan

[13] Teikyo Univ, Dept Cardiol, Sch Med, Tokyo, Japan

[14] Toyohashi Heart Ctr, Dept Cardiol, Toyohashi, Aichi, Japan

[15] Nagoya Heart Ctr, Dept Cardiol, Nagoya, Aichi, Japan

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2021年 / 10卷 / 07期

关键词：

heart failure; left ventricular end-diastolic dimension; left ventricular hypertrophy; propensity score matching; transcatheter aortic valve replacement; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; PARTNER TRIALS; HYPERTROPHY; IMPACT; ECHOCARDIOGRAPHY; RECOMMENDATIONS; IMPLANTATION; REGRESSION; MORTALITY;

D O I：

10.1161/JAHA.120.019543

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND: In patients undergoing transcatheter aortic valve replacement (TAVR), those with small left ventricle (LV) may have an increased risk of poor outcomes, because small LV is associated with low-flow (LF), left ventricular hypertrophy. However, the impact of small LV on patients undergoing TAVR remains unknown. METHODS AND RESULTS: We examined 2584 patients who underwent TAVR between October 2013 and May 2017 using data from the Japanese multicenter registry. On the basis of the American Society of Echocardiography guidelines, small LV was defined as left ventricular end-diastolic dimension <42.0 mm for men or <37.8 mm for women. The 2-year clinical outcomes were compared between patients with and without small LV using multivariable Cox regression analyses and propensity score matching. Subgroup analyses by LF, left ventricular hypertrophy were performed. Of 2584 patients who underwent TAVR, 466 (18.0%) had small LV. Patients with small LV had smaller body size and less comorbidity, and were more likely to have LF status compared with those without. Small LV was associated with a higher 2-year all-cause (20.8% versus 14.3%; adjusted hazard ratio [HR],1.58 [95% CI, 1.20-2.09]; P=0.0013) and cardiovascular mortality (8.8% versus 5.5%; adjusted HR, 1.93 [95% CI, 1.25-2.98]; P=0.0028). Propensity score matching analysis showed consistent findings. In subgroup analyses, LF, left ventricular hypertrophy did not interact with small LV. CONCLUSIONS: Small LV, determined by a simple echocardiographic parameter, was associated with poorer clinical outcomes after TAVR regardless of LF, left ventricular hypertrophy. LV size may be useful for assessing clinical outcomes after TAVR.

引用

页数：27

共 31 条

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