Zhang Juqian, Bisson Arnaud, Boumhidi Jad, Herbert Julien, Saint Etienne Christophe, Bernard Anne, Lip Gregory Y H, Fauchier Laurent
Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool L69 7ZX, UK.
Service de Cardiologie, Centre Hospitalier Universitaire et Faculté de Médecine, Université de Tours, CEDEX 1, 37044 Tours, France.
J Clin Med. 2021 Sep 2;10(17):3974. doi: 10.3390/jcm10173974.
Mitral regurgitation (MR) is the most common valvular lesion in transcatheter aortic valve implantation (TAVI) recipients. This study aims to assess the long-term prognostic impact of baseline MR in TAVI patients.
Adult patients who underwent TAVI were identified in the French National Hospital Discharge Database. All-cause and cardiovascular mortality, stroke, and rehospitalization with heart failure (HF) were compared in TAVI patients with and without baseline MR and tricuspid regurgitation (TR), respectively; the associations of MR and TR with the outcomes were assessed by Cox regression.
Baseline MR was identified in 8240 TAVI patients. Patients with baseline MR have higher yearly incidence of all-cause mortality (HR: 1.192, 95% confidence interval CI: 1.125-1.263), cardiovascular mortality (HR: 1.313, 95%CI: 1.210-1.425), and rehospitalization for heart failure (HF) (HR: 1.411, 95%CI: 1.340-1.486) compared to those without, except for stroke rate (HR: 0.988, 95%CI: 0.868-1.124). Neither baseline MR nor TR was an independent risk predictor for all-cause mortality or cardiovascular mortality in TAVI patients. Baseline MR was independently associated with rehospitalization for HF in TAVI patients.
Baseline MR and TR were associated with increased all-cause and cardiovascular mortality post-TAVI, however, neither of them was independent predictor for all-cause or cardiovascular mortality.
二尖瓣反流（MR）是经导管主动脉瓣植入术（TAVI）受者中最常见的瓣膜病变。本研究旨在评估TAVI患者基线MR的长期预后影响。
在法国国家医院出院数据库中识别接受TAVI的成年患者。分别比较有和无基线MR及三尖瓣反流（TR）的TAVI患者的全因死亡率、心血管死亡率、中风和因心力衰竭（HF）再次住院的情况；通过Cox回归评估MR和TR与结局的关联。
在8240例TAVI患者中识别出基线MR。与无基线MR的患者相比，有基线MR的患者全因死亡率（风险比[HR]：1.192，95%置信区间[CI]：1.125 - 1.263）、心血管死亡率（HR：1.313，95%CI：1.210 - 1.425）和因心力衰竭再次住院率（HR：1.411，95%CI：1.340 - 1.486）更高，但中风发生率（HR：0.988，95%CI：0.868 - 1.124）除外。在TAVI患者中，基线MR和TR均不是全因死亡率或心血管死亡率的独立风险预测因素。基线MR与TAVI患者因HF再次住院独立相关。
基线MR和TR与TAVI术后全因死亡率和心血管死亡率增加相关，然而，它们均不是全因或心血管死亡率的独立预测因素。
