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Prognostic Significance of Change in the Left Ventricular Ejection Fraction After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis and Left Ventricular Dysfunction.

作者信息

Angelillis Marco, Giannini Cristina, De Carlo Marco, Adamo Marianna, Nardi Matilde, Colombo Antonio, Chieffo Alaide, Bedogni Francesco, Brambilla Nedy, Tamburino Corrado, Barbanti Marco, Bruschi Giuseppe, Colombo Paola, Poli Arnaldo, Martina Paola, Violini Roberto, Presbitero Patrizia, Petronio Anna Sonia

机构信息

Cardio-Thoracic Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

Cardio-Thoracic Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

出版信息

Am J Cardiol. 2017 Nov 1;120(9):1639-1647. doi: 10.1016/j.amjcard.2017.07.064. Epub 2017 Aug 1.


DOI:10.1016/j.amjcard.2017.07.064
PMID:28844511
Abstract

Patients with severe aortic stenosis and reduced left ventricular ejection fraction (LVEF) have a poor prognosis compared with patients with preserved LVEF. To evaluate the impact of early LVEF recovery in patients with baseline dysfunction on clinical outcomes after transcatheter aortic valve implantation (TAVI), we included all consecutive patients who underwent TAVI from the Italian ClinicalService registry with an LVEF of ≤45% at baseline who had 1-month LVEF data. Patients who experienced a previous coronary artery bypass graft, a previous valve replacement, or a previous myocardial infarction were excluded from the analysis. Therefore, 131 patients with an improvement in LVEF of <10% (no-R group) were compared with 121 patients with an improvement in LVEF of ≥10% (R group). The primary end point was the rate of death of any cause. Multivariable analysis was performed to determine independent predictors of lack in LVEF recovery. Early LVEF recovery occurred in 48% of the patients, generally before discharge. One-year all-cause mortality and major adverse cardiac and cerebrovascular events were significantly higher in the no-early recovery group (log rank test p = 0.005 and p = 0.003, respectively). Baseline severe left ventricular dysfunction and previous percutaneous coronary intervention were identified as independent predictors to warn the lack of improvement in LVEF. In conclusion, nearly 50% of patients with preoperative left ventricular dysfunction demonstrated a significant early improvement in LVEF after TAVI. Lack of early LVEF recovery is associated with a worse clinical outcome and is most likely among patients with a severely abnormal baseline LVEF and a previous percutaneous coronary intervention.

摘要

相似文献

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Prognostic Significance of Change in the Left Ventricular Ejection Fraction After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis and Left Ventricular Dysfunction.

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[3]
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引用本文的文献

[1]
Echocardiographic Evaluation after Transcatheter Aortic Valve Implantation: A Comprehensive Review.

Life (Basel). 2023-4-24

[2]
Ubiquinol supplementation in elderly patients undergoing aortic valve replacement: biochemical and clinical aspects.

Aging (Albany NY). 2020-7-31

[3]
Predictors for non-delayed discharge after transcatheter aortic valve replacement: utility of echocardiographic parameters.

Int J Cardiovasc Imaging. 2021-1

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