First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI
Background: up to one-fifth of patients continue to have poor quality of life after transcatheter aortic valve implantation (TAVI), with an additional similar proportion not surviving 1 year after the procedure. We aimed to assess the value of a new method based on an integrated analysis of left ven...
| Authors: | ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; |
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| Format: | Article |
| Publication date: | 2023 |
| Country: | España |
| Institution: | Universidad de Cantabria (UC) |
| Repository: | UCrea Repositorio Abierto de la Universidad de Cantabria |
| Language: | English |
| OAI Identifier: | oai:repositorio.unican.es:10902/31273 |
| Online Access: | https://hdl.handle.net/10902/31273 |
| Access Level: | Open access |
| Keyword: | Aortic stenosis Transcatheter aortic valve implantation Clinical outcomes Aortic pressure Flow velocity Left ventricular outflow tract |
| _version_ | 1878734334494507008 |
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| author | Torre Hernández, José María de la |||0000-0003-4570-8902 |
| author2 | Veiga Fernández, Gabriela Ben-Assa, Eyal Iribarren, Julia Sainz Laso, Fermín Lee, Dae-Hyun Ruisánchez Villar, Cristina Lerena, Piedad García Camarero, Tamara Iribarren Sarrias, José L. Cuesta Cosgaya, M. Maza Fernández, María Emilia Garilleti, Celia Fradejas Sastre, Víctor|||0000-0002-2734-4335 Benito, Mercedes Barrera, Sergio Gil, Ongay Vázquez de Prada Tiffe, José Antonio|||0000-0002-8825-3867 Zueco, Javier |
| author2_role | author author author author author author author author author author author author author author author author author author |
| author_browse | Barrera, Sergio Ben-Assa, Eyal Benito, Mercedes Cuesta Cosgaya, M. Fradejas Sastre, Víctor|||0000-0002-2734-4335 García Camarero, Tamara Garilleti, Celia Gil, Ongay Iribarren Sarrias, José L. Iribarren, Julia Lee, Dae-Hyun Lerena, Piedad Maza Fernández, María Emilia Ruisánchez Villar, Cristina Sainz Laso, Fermín Torre Hernández, José María de la |||0000-0003-4570-8902 Veiga Fernández, Gabriela Vázquez de Prada Tiffe, José Antonio|||0000-0002-8825-3867 Zueco, Javier |
| author_facet | Torre Hernández, José María de la |||0000-0003-4570-8902 Veiga Fernández, Gabriela Ben-Assa, Eyal Iribarren, Julia Sainz Laso, Fermín Lee, Dae-Hyun Ruisánchez Villar, Cristina Lerena, Piedad García Camarero, Tamara Iribarren Sarrias, José L. Cuesta Cosgaya, M. Maza Fernández, María Emilia Garilleti, Celia Fradejas Sastre, Víctor|||0000-0002-2734-4335 Benito, Mercedes Barrera, Sergio Gil, Ongay Vázquez de Prada Tiffe, José Antonio|||0000-0002-8825-3867 Zueco, Javier |
| author_role | author |
| collection | UCrea Repositorio Abierto de la Universidad de Cantabria |
| description | Background: up to one-fifth of patients continue to have poor quality of life after transcatheter aortic valve implantation (TAVI), with an additional similar proportion not surviving 1 year after the procedure. We aimed to assess the value of a new method based on an integrated analysis of left ventricular outflow tract flow velocity and aortic pressure to predict objective functional improvement and prognosis after TAVI. Methods: in a cohort of consecutive patients undergoing TAVI, flow velocity-pressure integrated analysis was obtained from simultaneous pressure recordings in the ascending aorta and flow velocity recordings in the left ventricular outflow tract by echocardiography. Objective functional improvement 6 months after TAVI was assessed through changes in a 6-min walk test and NT-proBNP levels. A clinical follow-up was conducted at 2 years. Results: of the 102 patients studied, 82 (80.4%) showed objective functional improvement. The 2-year mortality of these patients was significantly lower (9% vs. 44%, p=0.001). In multivariate analysis, parameter "(Pressure at Vmax - Pressure at Vo)/Vmax" was found to be an independent predictor for objective improvement. The C-statistic was 0.70 in the overall population and 0.78 in the low-gradient subgroup. All echocardiographic parameters and the valvuloarterial impedance showed a C-statistic of <0.6 for the overall and low-gradient patients. In a validation cohort of 119 patients, the C-statistic was 0.67 for the total cohort and 0.76 for the low-gradient subgroup. Conclusion: this new method allows predicting objective functional improvement after TAVI more precisely than the conventional parameters used to assess the severity of aortic stenosis, particularly in low-gradient patients. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_67fbd13c1943c5b6d9f04a7238a809fb |
| institution | Universidad de Cantabria (UC) |
| instname_str | Universidad de Cantabria (UC) |
| language | eng |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:repositorio.unican.es:10902/31273 |
| publishDate | 2023 |
| publishDateSort | 2023 |
| publisher | Frontiers Media S.A. |
| publisherStr | Frontiers Media S.A. |
| reponame_str | UCrea Repositorio Abierto de la Universidad de Cantabria |
| spelling | First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI Torre Hernández, José María de la |||0000-0003-4570-8902 Veiga Fernández, Gabriela Ben-Assa, Eyal Iribarren, Julia Sainz Laso, Fermín Lee, Dae-Hyun Ruisánchez Villar, Cristina Lerena, Piedad García Camarero, Tamara Iribarren Sarrias, José L. Cuesta Cosgaya, M. Maza Fernández, María Emilia Garilleti, Celia Fradejas Sastre, Víctor|||0000-0002-2734-4335 Benito, Mercedes Barrera, Sergio Gil, Ongay Vázquez de Prada Tiffe, José Antonio|||0000-0002-8825-3867 Zueco, Javier Aortic stenosis Transcatheter aortic valve implantation Clinical outcomes Aortic pressure Flow velocity Left ventricular outflow tract Background: up to one-fifth of patients continue to have poor quality of life after transcatheter aortic valve implantation (TAVI), with an additional similar proportion not surviving 1 year after the procedure. We aimed to assess the value of a new method based on an integrated analysis of left ventricular outflow tract flow velocity and aortic pressure to predict objective functional improvement and prognosis after TAVI. Methods: in a cohort of consecutive patients undergoing TAVI, flow velocity-pressure integrated analysis was obtained from simultaneous pressure recordings in the ascending aorta and flow velocity recordings in the left ventricular outflow tract by echocardiography. Objective functional improvement 6 months after TAVI was assessed through changes in a 6-min walk test and NT-proBNP levels. A clinical follow-up was conducted at 2 years. Results: of the 102 patients studied, 82 (80.4%) showed objective functional improvement. The 2-year mortality of these patients was significantly lower (9% vs. 44%, p=0.001). In multivariate analysis, parameter "(Pressure at Vmax - Pressure at Vo)/Vmax" was found to be an independent predictor for objective improvement. The C-statistic was 0.70 in the overall population and 0.78 in the low-gradient subgroup. All echocardiographic parameters and the valvuloarterial impedance showed a C-statistic of <0.6 for the overall and low-gradient patients. In a validation cohort of 119 patients, the C-statistic was 0.67 for the total cohort and 0.76 for the low-gradient subgroup. Conclusion: this new method allows predicting objective functional improvement after TAVI more precisely than the conventional parameters used to assess the severity of aortic stenosis, particularly in low-gradient patients. Frontiers Media S.A. https://hdl.handle.net/10902/31273 |
| spellingShingle | First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI Torre Hernández, José María de la |||0000-0003-4570-8902 Aortic stenosis Transcatheter aortic valve implantation Clinical outcomes Aortic pressure Flow velocity Left ventricular outflow tract |
| title | First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI |
| title_full | First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI |
| title_fullStr | First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI |
| title_full_unstemmed | First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI |
| title_short | First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI |
| title_sort | First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI |
| topic | Aortic stenosis Transcatheter aortic valve implantation Clinical outcomes Aortic pressure Flow velocity Left ventricular outflow tract |
| topic_facet | Aortic stenosis Transcatheter aortic valve implantation Clinical outcomes Aortic pressure Flow velocity Left ventricular outflow tract |
| url | https://hdl.handle.net/10902/31273 |