000			04756nam a22007697a 4500
008			170428s20172017 xxu||||| |||| 00| 0 eng d
022			_a0002-8703
040			_aOvid MEDLINE(R)
099			_a28224928
245			_aImpact of right ventricular function on outcome of severe aortic stenosis patients undergoing transcatheter aortic valve replacement.
251			_aAmerican Heart Journal. 184:141-147, 2017 Feb
252			_aAm Heart J. 184:141-147, 2017 Feb
253			_aAmerican heart journal
260			_c2017
260			_fFY2017
266			_d2017-05-06
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aBACKGROUND: Right ventricular (RV) dysfunction was shown to be associated with adverse outcomes in a variety of cardiac patients and is considered a risk factor for adverse outcome according to the updated Valve Academic Research Consortium criteria.
520			_aCONCLUSIONS: Patients with severe AS and RV dysfunction have similar 1-year mortality and functional class after TAVR to patients with normal RV function. The presence of RV dysfunction does not correlate with outcome in patients with severe AS.
520			_aCopyright � 2016 Elsevier Inc. All rights reserved.
520			_aMETHODS: All patients with severe AS treated with TAVR from May 2007 to March 2015 at our center were included in the present study, and baseline and procedural characteristics were recorded for each patient. The patients were categorized according to RV function at baseline as assessed by current guidelines, and a comparison of mortality rates up to 1 year was performed.
520			_aOBJECTIVE: Our goal was to assess the impact of RV function at baseline on 1-year mortality among patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).
520			_aRESULTS: Among 650 patients, 606 had adequate echocardiogram quality and 146 (24%) had RV dysfunction. There were significant differences between the 2 groups, as patients with RV dysfunction were younger (81+/-9 vs 84+/-7 years, P=.01) and were more likely to be male (65% vs 42%, P<.001). In addition, patients with RV dysfunction had higher rates of prior myocardial infarction (26% vs 16%, P=.02) and atrial fibrillation (51% vs 39%, P=.02). Echocardiographic parameters demonstrated higher rates of left ventricular ejection fraction <40% (40% vs 18%, P<.001), tricuspid regurgitation above moderate (16% vs 9%, P=.04), and higher pulmonary artery systolic pressure (50+/-17 vs 44+/-16 mm Hg, P<.001) among patients with severe AS and RV dysfunction compared with patients with normal RV function. Despite the unfavorable cardiac function, patients with severe AS undergoing TAVR have similar functional class (P=.22) and mortality rates at 1year (27% vs 23%, log-rank P=.45).
546			_aEnglish
650			_a*Aortic Valve Stenosis/su [Surgery]
650			_a*Transcatheter Aortic Valve Replacement
650			_a*Ventricular Dysfunction, Right/pp [Physiopathology]
650			_aAged
650			_aAged, 80 and over
650			_aAortic Valve Stenosis/co [Complications]
650			_aEchocardiography
650			_aFemale
650			_aHumans
650			_aMale
650			_aMortality
650			_aPrognosis
650			_aProspective Studies
650			_aStroke Volume
650			_aTreatment Outcome
650			_aTricuspid Valve Insufficiency/co [Complications]
650			_aTricuspid Valve Insufficiency/dg [Diagnostic Imaging]
650			_aTricuspid Valve Insufficiency/pp [Physiopathology]
650			_aVentricular Dysfunction, Right/co [Complications]
650			_aVentricular Dysfunction, Right/dg [Diagnostic Imaging]
650			_aVentricular Function, Right
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
700			_aAsch, Federico M
700			_aBen-Dor, Itsik
700			_aDidier, Romain
700			_aGai, Jiaxiang
700			_aGoldstein, Steven A
700			_aJerusalem, Zack
700			_aKiramijyan, Starkis
700			_aKoifman, Edward
700			_aLipinski, Michael J
700			_aNegi, Smita I
700			_aPatel, Nirav
700			_aPichard, Augusto D
700			_aSatler, Lowell F
700			_aTorguson, Rebecca
700			_aWaksman, Ron
700			_aWang, Zuyue
790			_aAsch FM, Ben-Dor I, Didier R, Gai J, Goldstein SA, Jerusalem Z, Kiramijyan S, Koifman E, Lipinski MJ, Negi SI, Patel N, Pichard AD, Satler LF, Torguson R, Waksman R, Wang Z
856			_uhttps://dx.doi.org/10.1016/j.ahj.2016.09.018 _zhttps://dx.doi.org/10.1016/j.ahj.2016.09.018
942			_cART _dArticle
999			_c2409 _d2409