First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI

Background: up to one-fifth of patients continue to have poor quality of life after transcatheter aortic valve implantation (TAVI), with an additional similar proportion not surviving 1 year after the procedure. We aimed to assess the value of a new method based on an integrated analysis of left ven...

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Autores: Torre Hernández, José María de la |||0000-0003-4570-8902, Veiga Fernández, Gabriela, Ben-Assa, Eyal, Iribarren, Julia, Sainz Laso, Fermín, Lee, Dae-Hyun, Ruisánchez Villar, Cristina, Lerena, Piedad, García Camarero, Tamara, Iribarren Sarrias, José L., Cuesta Cosgaya, M., Maza Fernández, María Emilia, Garilleti, Celia, Fradejas Sastre, Víctor|||0000-0002-2734-4335, Benito, Mercedes, Barrera, Sergio, Gil, Ongay, Vázquez de Prada Tiffe, José Antonio|||0000-0002-8825-3867, Zueco, Javier
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universidad de Cantabria (UC)
Repositorio:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglés
OAI Identifier:oai:repositorio.unican.es:10902/31273
Acceso en línea:https://hdl.handle.net/10902/31273
Access Level:acceso abierto
Palabra clave:Aortic stenosis
Transcatheter aortic valve implantation
Clinical outcomes
Aortic pressure
Flow velocity
Left ventricular outflow tract
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spelling First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVITorre Hernández, José María de la |||0000-0003-4570-8902Veiga Fernández, GabrielaBen-Assa, EyalIribarren, JuliaSainz Laso, FermínLee, Dae-HyunRuisánchez Villar, CristinaLerena, PiedadGarcía Camarero, TamaraIribarren Sarrias, José L.Cuesta Cosgaya, M.Maza Fernández, María EmiliaGarilleti, CeliaFradejas Sastre, Víctor|||0000-0002-2734-4335Benito, MercedesBarrera, SergioGil, OngayVázquez de Prada Tiffe, José Antonio|||0000-0002-8825-3867Zueco, JavierAortic stenosisTranscatheter aortic valve implantationClinical outcomesAortic pressureFlow velocityLeft ventricular outflow tractBackground: up to one-fifth of patients continue to have poor quality of life after transcatheter aortic valve implantation (TAVI), with an additional similar proportion not surviving 1 year after the procedure. We aimed to assess the value of a new method based on an integrated analysis of left ventricular outflow tract flow velocity and aortic pressure to predict objective functional improvement and prognosis after TAVI. Methods: in a cohort of consecutive patients undergoing TAVI, flow velocity-pressure integrated analysis was obtained from simultaneous pressure recordings in the ascending aorta and flow velocity recordings in the left ventricular outflow tract by echocardiography. Objective functional improvement 6 months after TAVI was assessed through changes in a 6-min walk test and NT-proBNP levels. A clinical follow-up was conducted at 2 years. Results: of the 102 patients studied, 82 (80.4%) showed objective functional improvement. The 2-year mortality of these patients was significantly lower (9% vs. 44%, p=0.001). In multivariate analysis, parameter "(Pressure at Vmax - Pressure at Vo)/Vmax" was found to be an independent predictor for objective improvement. The C-statistic was 0.70 in the overall population and 0.78 in the low-gradient subgroup. All echocardiographic parameters and the valvuloarterial impedance showed a C-statistic of <0.6 for the overall and low-gradient patients. In a validation cohort of 119 patients, the C-statistic was 0.67 for the total cohort and 0.76 for the low-gradient subgroup. Conclusion: this new method allows predicting objective functional improvement after TAVI more precisely than the conventional parameters used to assess the severity of aortic stenosis, particularly in low-gradient patients.Frontiers Media S.A.Universidad de Cantabria20232023-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttps://hdl.handle.net/10902/31273Frontiers in Cardiovascular Medicine, 2023, 10, 1215826reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/312732026-06-02T12:39:31Z
dc.title.none.fl_str_mv First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI
title First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI
spellingShingle First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI
Torre Hernández, José María de la |||0000-0003-4570-8902
Aortic stenosis
Transcatheter aortic valve implantation
Clinical outcomes
Aortic pressure
Flow velocity
Left ventricular outflow tract
title_short First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI
title_full First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI
title_fullStr First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI
title_full_unstemmed First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI
title_sort First description and validation of a new method for estimating aortic stenosis burden and predicting the functional response to TAVI
dc.creator.none.fl_str_mv Torre Hernández, José María de la |||0000-0003-4570-8902
Veiga Fernández, Gabriela
Ben-Assa, Eyal
Iribarren, Julia
Sainz Laso, Fermín
Lee, Dae-Hyun
Ruisánchez Villar, Cristina
Lerena, Piedad
García Camarero, Tamara
Iribarren Sarrias, José L.
Cuesta Cosgaya, M.
Maza Fernández, María Emilia
Garilleti, Celia
Fradejas Sastre, Víctor|||0000-0002-2734-4335
Benito, Mercedes
Barrera, Sergio
Gil, Ongay
Vázquez de Prada Tiffe, José Antonio|||0000-0002-8825-3867
Zueco, Javier
author Torre Hernández, José María de la |||0000-0003-4570-8902
author_facet Torre Hernández, José María de la |||0000-0003-4570-8902
Veiga Fernández, Gabriela
Ben-Assa, Eyal
Iribarren, Julia
Sainz Laso, Fermín
Lee, Dae-Hyun
Ruisánchez Villar, Cristina
Lerena, Piedad
García Camarero, Tamara
Iribarren Sarrias, José L.
Cuesta Cosgaya, M.
Maza Fernández, María Emilia
Garilleti, Celia
Fradejas Sastre, Víctor|||0000-0002-2734-4335
Benito, Mercedes
Barrera, Sergio
Gil, Ongay
Vázquez de Prada Tiffe, José Antonio|||0000-0002-8825-3867
Zueco, Javier
author_role author
author2 Veiga Fernández, Gabriela
Ben-Assa, Eyal
Iribarren, Julia
Sainz Laso, Fermín
Lee, Dae-Hyun
Ruisánchez Villar, Cristina
Lerena, Piedad
García Camarero, Tamara
Iribarren Sarrias, José L.
Cuesta Cosgaya, M.
Maza Fernández, María Emilia
Garilleti, Celia
Fradejas Sastre, Víctor|||0000-0002-2734-4335
Benito, Mercedes
Barrera, Sergio
Gil, Ongay
Vázquez de Prada Tiffe, José Antonio|||0000-0002-8825-3867
Zueco, Javier
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
dc.subject.none.fl_str_mv Aortic stenosis
Transcatheter aortic valve implantation
Clinical outcomes
Aortic pressure
Flow velocity
Left ventricular outflow tract
topic Aortic stenosis
Transcatheter aortic valve implantation
Clinical outcomes
Aortic pressure
Flow velocity
Left ventricular outflow tract
description Background: up to one-fifth of patients continue to have poor quality of life after transcatheter aortic valve implantation (TAVI), with an additional similar proportion not surviving 1 year after the procedure. We aimed to assess the value of a new method based on an integrated analysis of left ventricular outflow tract flow velocity and aortic pressure to predict objective functional improvement and prognosis after TAVI. Methods: in a cohort of consecutive patients undergoing TAVI, flow velocity-pressure integrated analysis was obtained from simultaneous pressure recordings in the ascending aorta and flow velocity recordings in the left ventricular outflow tract by echocardiography. Objective functional improvement 6 months after TAVI was assessed through changes in a 6-min walk test and NT-proBNP levels. A clinical follow-up was conducted at 2 years. Results: of the 102 patients studied, 82 (80.4%) showed objective functional improvement. The 2-year mortality of these patients was significantly lower (9% vs. 44%, p=0.001). In multivariate analysis, parameter "(Pressure at Vmax - Pressure at Vo)/Vmax" was found to be an independent predictor for objective improvement. The C-statistic was 0.70 in the overall population and 0.78 in the low-gradient subgroup. All echocardiographic parameters and the valvuloarterial impedance showed a C-statistic of <0.6 for the overall and low-gradient patients. In a validation cohort of 119 patients, the C-statistic was 0.67 for the total cohort and 0.76 for the low-gradient subgroup. Conclusion: this new method allows predicting objective functional improvement after TAVI more precisely than the conventional parameters used to assess the severity of aortic stenosis, particularly in low-gradient patients.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10902/31273
url https://hdl.handle.net/10902/31273
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Frontiers Media S.A.
publisher.none.fl_str_mv Frontiers Media S.A.
dc.source.none.fl_str_mv Frontiers in Cardiovascular Medicine, 2023, 10, 1215826
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.301603

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