Echocardiographic Derived Parameters Association With Long-Term Outcomes After Transcatheter Valve Replacement

Mohammad Al-Akchar; Khalid Sawalha; Hadi Mahmaljy; Abdisamad M. Ibrahim; Mohsin Salih; Mukul Bhattarai; Shailesh Nandish; Sachin Goel; Nilesh J. Goswami; Jeffrey A. Goldstein; Zaher Fanari

doi:10.1016/j.carrev.2019.12.035

Echocardiographic Derived Parameters Association With Long-Term Outcomes After Transcatheter Valve Replacement

Mohammad Al-Akchar, Khalid Sawalha, Hadi Mahmaljy, Abdisamad M. Ibrahim, Mohsin Salih, Mukul Bhattarai, Shailesh Nandish, Sachin Goel, Nilesh J. Goswami, Jeffrey A. Goldstein, Zaher Fanari

Houston Methodist

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

BACKGROUND: Transaortic flow, maximum velocity (V max), mean gradient (MG), left ventricular ejection fraction (LVEF), Aortic valve area (AVA) and dimensional index (DI) are important determinants of prognosis in patients with severe aortic stenosis. The specific role of these echocardiography-derived values in predicting prognosis of severe aortic stenosis patients undergoing Transcatheter aortic valve replacement (TAVR) is less defined.

METHODS: We identified all severe AS patients who underwent TAVR between 01/2012 and 6/2016. Baseline characteristics, clinical, procedural and one year follow-up data were obtained. Hierarchical logistic regression was used to assess predictors of 1-year mortality after TAVR. Normal flow (NF) was defined as having stroke volume index (SVI) of ≥35 ml/m2; while low Flow (LF) was defined as SVI < 35 ml/m2. High gradient (HG) was defined as mean gradient of ≥40 mmHg; while low gradient (LG) was defined as <40 mmHg.

RESULTS: A total of 399 patients were analyzed. There were no significant differences in baseline characteristics. LVEF less than 35% was associated with higher rate of 1-year mortality (17.6% LVEF <35% vs. 8.9% LVEF≥35%; RR = 2.19; CI 1.05 to 4.54; P = 0.03). There was no difference in 1-year mortality outcomes after TAVR in relation to: Mean Gradient MG, transaortic flow/Stroke Volume Index SVI, DI, V max or AVA.

CONCLUSION: Low LVEF <35% remains the strongest parameter associated with 1 year mortality after TAVR.

Original language	English (US)
Pages (from-to)	982-985
Number of pages	4
Journal	Cardiovascular Revascularization Medicine
Volume	21
Issue number	8
DOIs	https://doi.org/10.1016/j.carrev.2019.12.035
State	Published - Aug 2020

Keywords

Echocardiogram
Mortality
Transcatheter valve replacement
Severity of Illness Index
Predictive Value of Tests
Risk Assessment
Ventricular Function, Left
Humans
Risk Factors
Male
Transcatheter Aortic Valve Replacement/adverse effects
Treatment Outcome
Aortic Valve Stenosis/diagnostic imaging
Stroke Volume
Time Factors
Blood Flow Velocity
Echocardiography, Doppler
Aged, 80 and over
Female
Aged
Retrospective Studies
Aortic Valve/diagnostic imaging

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.carrev.2019.12.035

Cite this

Al-Akchar, M., Sawalha, K., Mahmaljy, H., Ibrahim, A. M., Salih, M., Bhattarai, M., Nandish, S., Goel, S., Goswami, N. J., Goldstein, J. A., & Fanari, Z. (2020). Echocardiographic Derived Parameters Association With Long-Term Outcomes After Transcatheter Valve Replacement. Cardiovascular Revascularization Medicine, 21(8), 982-985. https://doi.org/10.1016/j.carrev.2019.12.035

Al-Akchar, M, Sawalha, K, Mahmaljy, H, Ibrahim, AM, Salih, M, Bhattarai, M, Nandish, S, Goel, S, Goswami, NJ, Goldstein, JA & Fanari, Z 2020, 'Echocardiographic Derived Parameters Association With Long-Term Outcomes After Transcatheter Valve Replacement', Cardiovascular Revascularization Medicine, vol. 21, no. 8, pp. 982-985. https://doi.org/10.1016/j.carrev.2019.12.035

@article{662510b043db4227bfd534123b1c133d,

title = "Echocardiographic Derived Parameters Association With Long-Term Outcomes After Transcatheter Valve Replacement",

abstract = "BACKGROUND: Transaortic flow, maximum velocity (V max), mean gradient (MG), left ventricular ejection fraction (LVEF), Aortic valve area (AVA) and dimensional index (DI) are important determinants of prognosis in patients with severe aortic stenosis. The specific role of these echocardiography-derived values in predicting prognosis of severe aortic stenosis patients undergoing Transcatheter aortic valve replacement (TAVR) is less defined.METHODS: We identified all severe AS patients who underwent TAVR between 01/2012 and 6/2016. Baseline characteristics, clinical, procedural and one year follow-up data were obtained. Hierarchical logistic regression was used to assess predictors of 1-year mortality after TAVR. Normal flow (NF) was defined as having stroke volume index (SVI) of ≥35 ml/m2; while low Flow (LF) was defined as SVI < 35 ml/m2. High gradient (HG) was defined as mean gradient of ≥40 mmHg; while low gradient (LG) was defined as <40 mmHg.RESULTS: A total of 399 patients were analyzed. There were no significant differences in baseline characteristics. LVEF less than 35% was associated with higher rate of 1-year mortality (17.6% LVEF <35% vs. 8.9% LVEF≥35%; RR = 2.19; CI 1.05 to 4.54; P = 0.03). There was no difference in 1-year mortality outcomes after TAVR in relation to: Mean Gradient MG, transaortic flow/Stroke Volume Index SVI, DI, V max or AVA.CONCLUSION: Low LVEF <35% remains the strongest parameter associated with 1 year mortality after TAVR.",

keywords = "Echocardiogram, Mortality, Transcatheter valve replacement, Severity of Illness Index, Predictive Value of Tests, Risk Assessment, Ventricular Function, Left, Humans, Risk Factors, Male, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome, Aortic Valve Stenosis/diagnostic imaging, Stroke Volume, Time Factors, Blood Flow Velocity, Echocardiography, Doppler, Aged, 80 and over, Female, Aged, Retrospective Studies, Aortic Valve/diagnostic imaging",

author = "Mohammad Al-Akchar and Khalid Sawalha and Hadi Mahmaljy and Ibrahim, {Abdisamad M.} and Mohsin Salih and Mukul Bhattarai and Shailesh Nandish and Sachin Goel and Goswami, {Nilesh J.} and Goldstein, {Jeffrey A.} and Zaher Fanari",

year = "2020",

month = aug,

doi = "10.1016/j.carrev.2019.12.035",

language = "English (US)",

volume = "21",

pages = "982--985",

journal = "Cardiovascular Revascularization Medicine",

issn = "1553-8389",

publisher = "Elsevier",

number = "8",

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TY - JOUR

T1 - Echocardiographic Derived Parameters Association With Long-Term Outcomes After Transcatheter Valve Replacement

AU - Al-Akchar, Mohammad

AU - Sawalha, Khalid

AU - Mahmaljy, Hadi

AU - Ibrahim, Abdisamad M.

AU - Salih, Mohsin

AU - Bhattarai, Mukul

AU - Nandish, Shailesh

AU - Goel, Sachin

AU - Goswami, Nilesh J.

AU - Goldstein, Jeffrey A.

AU - Fanari, Zaher

PY - 2020/8

Y1 - 2020/8

N2 - BACKGROUND: Transaortic flow, maximum velocity (V max), mean gradient (MG), left ventricular ejection fraction (LVEF), Aortic valve area (AVA) and dimensional index (DI) are important determinants of prognosis in patients with severe aortic stenosis. The specific role of these echocardiography-derived values in predicting prognosis of severe aortic stenosis patients undergoing Transcatheter aortic valve replacement (TAVR) is less defined.METHODS: We identified all severe AS patients who underwent TAVR between 01/2012 and 6/2016. Baseline characteristics, clinical, procedural and one year follow-up data were obtained. Hierarchical logistic regression was used to assess predictors of 1-year mortality after TAVR. Normal flow (NF) was defined as having stroke volume index (SVI) of ≥35 ml/m2; while low Flow (LF) was defined as SVI < 35 ml/m2. High gradient (HG) was defined as mean gradient of ≥40 mmHg; while low gradient (LG) was defined as <40 mmHg.RESULTS: A total of 399 patients were analyzed. There were no significant differences in baseline characteristics. LVEF less than 35% was associated with higher rate of 1-year mortality (17.6% LVEF <35% vs. 8.9% LVEF≥35%; RR = 2.19; CI 1.05 to 4.54; P = 0.03). There was no difference in 1-year mortality outcomes after TAVR in relation to: Mean Gradient MG, transaortic flow/Stroke Volume Index SVI, DI, V max or AVA.CONCLUSION: Low LVEF <35% remains the strongest parameter associated with 1 year mortality after TAVR.

AB - BACKGROUND: Transaortic flow, maximum velocity (V max), mean gradient (MG), left ventricular ejection fraction (LVEF), Aortic valve area (AVA) and dimensional index (DI) are important determinants of prognosis in patients with severe aortic stenosis. The specific role of these echocardiography-derived values in predicting prognosis of severe aortic stenosis patients undergoing Transcatheter aortic valve replacement (TAVR) is less defined.METHODS: We identified all severe AS patients who underwent TAVR between 01/2012 and 6/2016. Baseline characteristics, clinical, procedural and one year follow-up data were obtained. Hierarchical logistic regression was used to assess predictors of 1-year mortality after TAVR. Normal flow (NF) was defined as having stroke volume index (SVI) of ≥35 ml/m2; while low Flow (LF) was defined as SVI < 35 ml/m2. High gradient (HG) was defined as mean gradient of ≥40 mmHg; while low gradient (LG) was defined as <40 mmHg.RESULTS: A total of 399 patients were analyzed. There were no significant differences in baseline characteristics. LVEF less than 35% was associated with higher rate of 1-year mortality (17.6% LVEF <35% vs. 8.9% LVEF≥35%; RR = 2.19; CI 1.05 to 4.54; P = 0.03). There was no difference in 1-year mortality outcomes after TAVR in relation to: Mean Gradient MG, transaortic flow/Stroke Volume Index SVI, DI, V max or AVA.CONCLUSION: Low LVEF <35% remains the strongest parameter associated with 1 year mortality after TAVR.

KW - Echocardiogram

KW - Mortality

KW - Transcatheter valve replacement

KW - Severity of Illness Index

KW - Predictive Value of Tests

KW - Risk Assessment

KW - Ventricular Function, Left

KW - Humans

KW - Risk Factors

KW - Male

KW - Transcatheter Aortic Valve Replacement/adverse effects

KW - Treatment Outcome

KW - Aortic Valve Stenosis/diagnostic imaging

KW - Stroke Volume

KW - Time Factors

KW - Blood Flow Velocity

KW - Echocardiography, Doppler

KW - Aged, 80 and over

KW - Female

KW - Aged

KW - Retrospective Studies

KW - Aortic Valve/diagnostic imaging

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Echocardiographic Derived Parameters Association With Long-Term Outcomes After Transcatheter Valve Replacement

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