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Article: Impact of valvuloarterial impedance on 2-year outcome of patients undergoing transcatheter aortic valve implantation
Title | Impact of valvuloarterial impedance on 2-year outcome of patients undergoing transcatheter aortic valve implantation |
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Authors | |
Keywords | Aged, 80 and over Aortic Valve/physiopathology/*surgery/*ultrasonography Aortic Valve Stenosis/mortality/physiopathology/*surgery/*ultrasonography *Cardiac Catheterization *Echocardiography, Doppler Female *Heart Valve Prosthesis Heart Valve Prosthesis Implantation/*methods/mortality Humans Male Prognosis Proportional Hazards Models Retrospective Studies Risk Factors Severity of Illness Index Survival Rate Vascular Resistance |
Issue Date | 2013 |
Citation | Journal of The American Society of Echocardiography, 2013, v. 26 n. 7, p. 691-698 How to Cite? |
Abstract | BACKGROUND: Elderly patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) often have increased calcification and fibrosis of the aorta. Indices that account for the severity of valvular obstruction and systemic vascular impedance may better assess total left ventricular afterload. The aims of the present study were to evaluate changes in valvuloarterial impedance (Zva), systemic arterial compliance, and systemic vascular resistance after TAVI and to investigate the prognostic value of these parameters. METHODS: A total of 116 patients (49% men; mean age, 81 +/- 8 years) with symptomatic severe aortic stenosis underwent TAVI. Zva, systemic arterial compliance, and systemic vascular resistance were measured at baseline and 1 and 12 months after TAVI. The primary end point was all-cause mortality. RESULTS: After TAVI, there was a significant reduction in Zva (from 5.40 +/- 1.52 mm Hg/mL/m(2) at baseline to 4.13 +/- 1.17 mm Hg/mL/m(2) at 1 month and 4.35 +/- 1.38 mm Hg/mL/m(2) at 1 year, P < .001). Systemic arterial compliance (from 0.57 +/- 0.27 to 0.57 +/- 0.28 and 0.53 +/- 0.27 mL/m(2)/mm Hg, P = .408) and systemic vascular resistance (from 1,938 +/- 669 to 1,856 +/- 888 and 1,871 +/- 767, dyne.s.cm(-5), P = .697) did not change significantly over time. During a median follow-up period of 25 months, survival rates of patients with baseline Zva >/= 5 mm Hg/mL/m(2) were lower compared with those with Zva < 5 mm Hg/mL/m(2) (82% vs 91%, respectively, log-rank P = .04). On multivariate Cox proportional-hazards analysis, baseline Zva was independently associated with all-cause mortality (hazard ratio, 1.48; 95% confidence interval, 1.05-2.07; P = .025). CONCLUSIONS: In patients undergoing TAVI, there is a significant postprocedural reduction in Zva, but there is no reduction in systemic arterial compliance or vascular resistance. Baseline Zva is an independent predictor of overall mortality at 2-year follow-up. |
Persistent Identifier | http://hdl.handle.net/10722/207692 |
ISSN | 2023 Impact Factor: 5.4 2023 SCImago Journal Rankings: 2.041 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Katsanos, S | en_US |
dc.contributor.author | Yiu, KH | en_US |
dc.contributor.author | Clavel, MA | en_US |
dc.contributor.author | Rodes-Cabau, J | en_US |
dc.contributor.author | Leong, D | en_US |
dc.contributor.author | van der Kley, F | en_US |
dc.contributor.author | Ajmone Marsan, N | en_US |
dc.contributor.author | Bax, JJ | en_US |
dc.contributor.author | Pibarot, P | en_US |
dc.contributor.author | Delgado, V | en_US |
dc.date.accessioned | 2015-01-19T04:20:05Z | - |
dc.date.available | 2015-01-19T04:20:05Z | - |
dc.date.issued | 2013 | en_US |
dc.identifier.citation | Journal of The American Society of Echocardiography, 2013, v. 26 n. 7, p. 691-698 | en_US |
dc.identifier.issn | 0894-7317 | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/207692 | - |
dc.description.abstract | BACKGROUND: Elderly patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) often have increased calcification and fibrosis of the aorta. Indices that account for the severity of valvular obstruction and systemic vascular impedance may better assess total left ventricular afterload. The aims of the present study were to evaluate changes in valvuloarterial impedance (Zva), systemic arterial compliance, and systemic vascular resistance after TAVI and to investigate the prognostic value of these parameters. METHODS: A total of 116 patients (49% men; mean age, 81 +/- 8 years) with symptomatic severe aortic stenosis underwent TAVI. Zva, systemic arterial compliance, and systemic vascular resistance were measured at baseline and 1 and 12 months after TAVI. The primary end point was all-cause mortality. RESULTS: After TAVI, there was a significant reduction in Zva (from 5.40 +/- 1.52 mm Hg/mL/m(2) at baseline to 4.13 +/- 1.17 mm Hg/mL/m(2) at 1 month and 4.35 +/- 1.38 mm Hg/mL/m(2) at 1 year, P < .001). Systemic arterial compliance (from 0.57 +/- 0.27 to 0.57 +/- 0.28 and 0.53 +/- 0.27 mL/m(2)/mm Hg, P = .408) and systemic vascular resistance (from 1,938 +/- 669 to 1,856 +/- 888 and 1,871 +/- 767, dyne.s.cm(-5), P = .697) did not change significantly over time. During a median follow-up period of 25 months, survival rates of patients with baseline Zva >/= 5 mm Hg/mL/m(2) were lower compared with those with Zva < 5 mm Hg/mL/m(2) (82% vs 91%, respectively, log-rank P = .04). On multivariate Cox proportional-hazards analysis, baseline Zva was independently associated with all-cause mortality (hazard ratio, 1.48; 95% confidence interval, 1.05-2.07; P = .025). CONCLUSIONS: In patients undergoing TAVI, there is a significant postprocedural reduction in Zva, but there is no reduction in systemic arterial compliance or vascular resistance. Baseline Zva is an independent predictor of overall mortality at 2-year follow-up. | en_US |
dc.language | eng | en_US |
dc.relation.ispartof | Journal of The American Society of Echocardiography | en_US |
dc.subject | Aged, 80 and over | en_US |
dc.subject | Aortic Valve/physiopathology/*surgery/*ultrasonography | en_US |
dc.subject | Aortic Valve Stenosis/mortality/physiopathology/*surgery/*ultrasonography | en_US |
dc.subject | *Cardiac Catheterization | en_US |
dc.subject | *Echocardiography, Doppler | en_US |
dc.subject | Female | en_US |
dc.subject | *Heart Valve Prosthesis | en_US |
dc.subject | Heart Valve Prosthesis Implantation/*methods/mortality | en_US |
dc.subject | Humans | en_US |
dc.subject | Male | en_US |
dc.subject | Prognosis | en_US |
dc.subject | Proportional Hazards Models | en_US |
dc.subject | Retrospective Studies | en_US |
dc.subject | Risk Factors | en_US |
dc.subject | Severity of Illness Index | en_US |
dc.subject | Survival Rate | en_US |
dc.subject | Vascular Resistance | en_US |
dc.title | Impact of valvuloarterial impedance on 2-year outcome of patients undergoing transcatheter aortic valve implantation | en_US |
dc.type | Article | en_US |
dc.identifier.email | Yiu, KH: khkyiu@hku.hk | en_US |
dc.identifier.authority | Yiu, KH=rp01490 | en_US |
dc.identifier.doi | 10.1016/j.echo.2013.04.003 | en_US |
dc.identifier.scopus | eid_2-s2.0-84879410452 | - |
dc.identifier.hkuros | 254857 | - |
dc.identifier.volume | 26 | en_US |
dc.identifier.issue | 7 | en_US |
dc.identifier.spage | 691 | en_US |
dc.identifier.epage | 698 | en_US |
dc.identifier.isi | WOS:000321051000002 | - |
dc.identifier.issnl | 0894-7317 | - |