Association between valvuloarterial impedance after transcatheter aortic valve implantation and 2-year mortality in elderly patients with severe symptomatic aortic stenosis: the OCEAN-TAVI registry

the OCEAN-TAVI investigators

Research output: Contribution to journalArticle

Abstract

Pre-procedural valvuloarterial impedance (Zva) is considered as a useful predictor of mortality in patients diagnosed as having severe aortic stenosis (AS) who undergo transcatheter aortic valve implantation (TAVI). However, the prognostic significance of post-procedural Zva remains unclear. We aimed to evaluate the prognostic significance of Zva after TAVI. We retrospectively analyzed the clinical and echocardiographic data of 1004 consecutive elderly patients (median 84 years old, 27.5% men) who underwent TAVI for severe symptomatic AS. Zva was calculated after TAVI, and patients were divided into three groups based on tertile values: the high [> 3.33 (n = 335)], intermediate [2.49–3.33 (n = 334)], and low Zva groups [< 2.49 (n = 335)]. The estimated 2-year all-cause and cardiovascular mortalities using Kaplan–Meier analysis were 16.2% [95% confidence interval (CI) 11.8–20.4] and 5.9% (95% CI 3.2–8.6), respectively. There were no significant intergroup differences in each endpoint (long-rank p = 0.518 for all-cause mortality, p = 0.757 for cardiovascular mortality). Multivariable Cox regression analyzes with adjustments of patient characteristics and medications showed that the post-procedural Zva was not associated with the 2-year all-cause mortality [intermediate Zva group versus (vs.) low Zva group: adjusted hazard ratio (aHR) = 1.34, 95% CI 0.75–2.40, p = 0.316; high Zva group vs. low Zva group: aHR = 1.17, 95% CI 0.64–2.16, p = 0.613] and cardiovascular mortality (intermediate Zva group vs. low Zva group: aHR = 1.50, 95% CI 0.56–4.06, p = 0.421; high Zva group vs. low Zva group: aHR = 1.25, 95% CI 0.43–3.65, p = 0.682). Our results suggest that post-procedural Zva was not associated with 2-year all-cause or cardiovascular mortalities in patients with severe symptomatic AS who underwent TAVI.

Original languageEnglish
JournalHeart and Vessels
DOIs
Publication statusAccepted/In press - 2019 Jan 1

Fingerprint

Aortic Valve Stenosis
Electric Impedance
Registries
Confidence Intervals
Mortality
Transcatheter Aortic Valve Replacement
Regression Analysis

Keywords

  • Aortic stenosis
  • Stroke Volume Index
  • Transcatheter aortic valve implantation
  • Valvuloarterial impedance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{019f729ac7c1456aa177c8677a59a9a2,
title = "Association between valvuloarterial impedance after transcatheter aortic valve implantation and 2-year mortality in elderly patients with severe symptomatic aortic stenosis: the OCEAN-TAVI registry",
abstract = "Pre-procedural valvuloarterial impedance (Zva) is considered as a useful predictor of mortality in patients diagnosed as having severe aortic stenosis (AS) who undergo transcatheter aortic valve implantation (TAVI). However, the prognostic significance of post-procedural Zva remains unclear. We aimed to evaluate the prognostic significance of Zva after TAVI. We retrospectively analyzed the clinical and echocardiographic data of 1004 consecutive elderly patients (median 84 years old, 27.5{\%} men) who underwent TAVI for severe symptomatic AS. Zva was calculated after TAVI, and patients were divided into three groups based on tertile values: the high [> 3.33 (n = 335)], intermediate [2.49–3.33 (n = 334)], and low Zva groups [< 2.49 (n = 335)]. The estimated 2-year all-cause and cardiovascular mortalities using Kaplan–Meier analysis were 16.2{\%} [95{\%} confidence interval (CI) 11.8–20.4] and 5.9{\%} (95{\%} CI 3.2–8.6), respectively. There were no significant intergroup differences in each endpoint (long-rank p = 0.518 for all-cause mortality, p = 0.757 for cardiovascular mortality). Multivariable Cox regression analyzes with adjustments of patient characteristics and medications showed that the post-procedural Zva was not associated with the 2-year all-cause mortality [intermediate Zva group versus (vs.) low Zva group: adjusted hazard ratio (aHR) = 1.34, 95{\%} CI 0.75–2.40, p = 0.316; high Zva group vs. low Zva group: aHR = 1.17, 95{\%} CI 0.64–2.16, p = 0.613] and cardiovascular mortality (intermediate Zva group vs. low Zva group: aHR = 1.50, 95{\%} CI 0.56–4.06, p = 0.421; high Zva group vs. low Zva group: aHR = 1.25, 95{\%} CI 0.43–3.65, p = 0.682). Our results suggest that post-procedural Zva was not associated with 2-year all-cause or cardiovascular mortalities in patients with severe symptomatic AS who underwent TAVI.",
keywords = "Aortic stenosis, Stroke Volume Index, Transcatheter aortic valve implantation, Valvuloarterial impedance",
author = "{the OCEAN-TAVI investigators} and Fukuko Nagura and Akihisa Kataoka and Masahiko Hara and Ken Kozuma and Yusuke Watanabe and Makoto Nakashima and Hirofumi Hioki and Hideyuki Kawashima and Yugo Nara and Shinichi Shirai and Norio Tada and Motoharu Araki and Toru Naganuma and Futoshi Yamanaka and Hiroshi Ueno and Minoru Tabata and Kazuki Mizutani and Akihiro Higashimori and Kensuke Takagi and Masanori Yamamoto and Kentaro Hayashida",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00380-018-01329-2",
language = "English",
journal = "Heart and Vessels",
issn = "0910-8327",
publisher = "Springer Japan",

}

TY - JOUR

T1 - Association between valvuloarterial impedance after transcatheter aortic valve implantation and 2-year mortality in elderly patients with severe symptomatic aortic stenosis

T2 - the OCEAN-TAVI registry

AU - the OCEAN-TAVI investigators

AU - Nagura, Fukuko

AU - Kataoka, Akihisa

AU - Hara, Masahiko

AU - Kozuma, Ken

AU - Watanabe, Yusuke

AU - Nakashima, Makoto

AU - Hioki, Hirofumi

AU - Kawashima, Hideyuki

AU - Nara, Yugo

AU - Shirai, Shinichi

AU - Tada, Norio

AU - Araki, Motoharu

AU - Naganuma, Toru

AU - Yamanaka, Futoshi

AU - Ueno, Hiroshi

AU - Tabata, Minoru

AU - Mizutani, Kazuki

AU - Higashimori, Akihiro

AU - Takagi, Kensuke

AU - Yamamoto, Masanori

AU - Hayashida, Kentaro

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Pre-procedural valvuloarterial impedance (Zva) is considered as a useful predictor of mortality in patients diagnosed as having severe aortic stenosis (AS) who undergo transcatheter aortic valve implantation (TAVI). However, the prognostic significance of post-procedural Zva remains unclear. We aimed to evaluate the prognostic significance of Zva after TAVI. We retrospectively analyzed the clinical and echocardiographic data of 1004 consecutive elderly patients (median 84 years old, 27.5% men) who underwent TAVI for severe symptomatic AS. Zva was calculated after TAVI, and patients were divided into three groups based on tertile values: the high [> 3.33 (n = 335)], intermediate [2.49–3.33 (n = 334)], and low Zva groups [< 2.49 (n = 335)]. The estimated 2-year all-cause and cardiovascular mortalities using Kaplan–Meier analysis were 16.2% [95% confidence interval (CI) 11.8–20.4] and 5.9% (95% CI 3.2–8.6), respectively. There were no significant intergroup differences in each endpoint (long-rank p = 0.518 for all-cause mortality, p = 0.757 for cardiovascular mortality). Multivariable Cox regression analyzes with adjustments of patient characteristics and medications showed that the post-procedural Zva was not associated with the 2-year all-cause mortality [intermediate Zva group versus (vs.) low Zva group: adjusted hazard ratio (aHR) = 1.34, 95% CI 0.75–2.40, p = 0.316; high Zva group vs. low Zva group: aHR = 1.17, 95% CI 0.64–2.16, p = 0.613] and cardiovascular mortality (intermediate Zva group vs. low Zva group: aHR = 1.50, 95% CI 0.56–4.06, p = 0.421; high Zva group vs. low Zva group: aHR = 1.25, 95% CI 0.43–3.65, p = 0.682). Our results suggest that post-procedural Zva was not associated with 2-year all-cause or cardiovascular mortalities in patients with severe symptomatic AS who underwent TAVI.

AB - Pre-procedural valvuloarterial impedance (Zva) is considered as a useful predictor of mortality in patients diagnosed as having severe aortic stenosis (AS) who undergo transcatheter aortic valve implantation (TAVI). However, the prognostic significance of post-procedural Zva remains unclear. We aimed to evaluate the prognostic significance of Zva after TAVI. We retrospectively analyzed the clinical and echocardiographic data of 1004 consecutive elderly patients (median 84 years old, 27.5% men) who underwent TAVI for severe symptomatic AS. Zva was calculated after TAVI, and patients were divided into three groups based on tertile values: the high [> 3.33 (n = 335)], intermediate [2.49–3.33 (n = 334)], and low Zva groups [< 2.49 (n = 335)]. The estimated 2-year all-cause and cardiovascular mortalities using Kaplan–Meier analysis were 16.2% [95% confidence interval (CI) 11.8–20.4] and 5.9% (95% CI 3.2–8.6), respectively. There were no significant intergroup differences in each endpoint (long-rank p = 0.518 for all-cause mortality, p = 0.757 for cardiovascular mortality). Multivariable Cox regression analyzes with adjustments of patient characteristics and medications showed that the post-procedural Zva was not associated with the 2-year all-cause mortality [intermediate Zva group versus (vs.) low Zva group: adjusted hazard ratio (aHR) = 1.34, 95% CI 0.75–2.40, p = 0.316; high Zva group vs. low Zva group: aHR = 1.17, 95% CI 0.64–2.16, p = 0.613] and cardiovascular mortality (intermediate Zva group vs. low Zva group: aHR = 1.50, 95% CI 0.56–4.06, p = 0.421; high Zva group vs. low Zva group: aHR = 1.25, 95% CI 0.43–3.65, p = 0.682). Our results suggest that post-procedural Zva was not associated with 2-year all-cause or cardiovascular mortalities in patients with severe symptomatic AS who underwent TAVI.

KW - Aortic stenosis

KW - Stroke Volume Index

KW - Transcatheter aortic valve implantation

KW - Valvuloarterial impedance

UR - http://www.scopus.com/inward/record.url?scp=85059307168&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059307168&partnerID=8YFLogxK

U2 - 10.1007/s00380-018-01329-2

DO - 10.1007/s00380-018-01329-2

M3 - Article

AN - SCOPUS:85059307168

JO - Heart and Vessels

JF - Heart and Vessels

SN - 0910-8327

ER -