Impact of restrictive versus obstructive pulmonary function patterns on mortality in patients undergoing transcatheter aortic valve implantation.
Impact of restrictive versus obstructive pulmonary function patterns on mortality in patients undergoing transcatheter aortic valve implantation.
- 2016
Available in print through MWHC library: 2002 - present
BACKGROUND: Pulmonary function tests to estimate force vital capacity (FVC) and forced expiratory volume in the first second (FEV1) have increasingly been used in patients evaluated for transcatheter aortic valve implantation (TAVI). The impact of obstructive versus restrictive lung disease on mortality remains unclear. The authors sought to identify differences in survival in patients with 2 distinct pulmonary function patterns (obstruction vs. restriction). CONCLUSION: In the current era, the pattern on pulmonary function tests and FEV1 values should not influence the decision on whom to offer a transcatheter option for their severe valvular disease. Copyright © 2016 Elsevier Inc. All rights reserved. METHODS: The authors retrospectively analyzed all patients with abnormal FEV1 (lower than 80% of predicted) detected on the pulmonary function tests prior to TAVI from May 2011 to November 2014. Patients were divided into a group with obstructive pattern (FEV1/FVC<70% of predicted) and a group with restrictive pattern (FEV1/FVC>70% of predicted). Cox proportional hazards regression was used to explore the impact of FEV1 on mortality. RESULTS: A total of 94 patients were included in this analysis. Forty-one percent (n=38) had obstructive pattern, and 59% (n=56) had restrictive pattern. FEV1 values were similar between both groups (43+/-19 vs. 42+/-26, p=0.89). Both groups had similar rates of in-hospital, 30-day, and 1-year mortality. FEV1 was not a correlate for 1-year mortality. Patients with pulmonary obstructive and restrictive patters had similar rates of mortality. Moreover, FEV1 value is not a correlate for 1-year mortality.
English
1878-0938
*Aortic Valve Stenosis/th [Therapy]
*Cardiac Catheterization/mo [Mortality]
*Heart Valve Prosthesis Implantation/mo [Mortality]
*Lung/pp [Physiopathology]
*Pulmonary Disease, Chronic Obstructive/pp [Physiopathology]
Aged
Aged, 80 and over
Aortic Valve Stenosis/di [Diagnosis]
Aortic Valve Stenosis/mo [Mortality]
Aortic Valve Stenosis/pp [Physiopathology]
Aortic Valve/pp [Physiopathology]
Cardiac Catheterization/ae [Adverse Effects]
Cardiac Catheterization/mt [Methods]
Disease-Free Survival
Female
Forced Expiratory Volume
Heart Valve Prosthesis Implantation/ae [Adverse Effects]
Heart Valve Prosthesis Implantation/mt [Methods]
Hemodynamics
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Patient Selection
Predictive Value of Tests
Proportional Hazards Models
Pulmonary Disease, Chronic Obstructive/di [Diagnosis]
Pulmonary Disease, Chronic Obstructive/mo [Mortality]
Retrospective Studies
Risk Assessment
Risk Factors
Spirometry
Time Factors
Treatment Outcome
Vital Capacity
MedStar Heart & Vascular Institute
Comparative Study
Journal Article
Available in print through MWHC library: 2002 - present
BACKGROUND: Pulmonary function tests to estimate force vital capacity (FVC) and forced expiratory volume in the first second (FEV1) have increasingly been used in patients evaluated for transcatheter aortic valve implantation (TAVI). The impact of obstructive versus restrictive lung disease on mortality remains unclear. The authors sought to identify differences in survival in patients with 2 distinct pulmonary function patterns (obstruction vs. restriction). CONCLUSION: In the current era, the pattern on pulmonary function tests and FEV1 values should not influence the decision on whom to offer a transcatheter option for their severe valvular disease. Copyright © 2016 Elsevier Inc. All rights reserved. METHODS: The authors retrospectively analyzed all patients with abnormal FEV1 (lower than 80% of predicted) detected on the pulmonary function tests prior to TAVI from May 2011 to November 2014. Patients were divided into a group with obstructive pattern (FEV1/FVC<70% of predicted) and a group with restrictive pattern (FEV1/FVC>70% of predicted). Cox proportional hazards regression was used to explore the impact of FEV1 on mortality. RESULTS: A total of 94 patients were included in this analysis. Forty-one percent (n=38) had obstructive pattern, and 59% (n=56) had restrictive pattern. FEV1 values were similar between both groups (43+/-19 vs. 42+/-26, p=0.89). Both groups had similar rates of in-hospital, 30-day, and 1-year mortality. FEV1 was not a correlate for 1-year mortality. Patients with pulmonary obstructive and restrictive patters had similar rates of mortality. Moreover, FEV1 value is not a correlate for 1-year mortality.
English
1878-0938
*Aortic Valve Stenosis/th [Therapy]
*Cardiac Catheterization/mo [Mortality]
*Heart Valve Prosthesis Implantation/mo [Mortality]
*Lung/pp [Physiopathology]
*Pulmonary Disease, Chronic Obstructive/pp [Physiopathology]
Aged
Aged, 80 and over
Aortic Valve Stenosis/di [Diagnosis]
Aortic Valve Stenosis/mo [Mortality]
Aortic Valve Stenosis/pp [Physiopathology]
Aortic Valve/pp [Physiopathology]
Cardiac Catheterization/ae [Adverse Effects]
Cardiac Catheterization/mt [Methods]
Disease-Free Survival
Female
Forced Expiratory Volume
Heart Valve Prosthesis Implantation/ae [Adverse Effects]
Heart Valve Prosthesis Implantation/mt [Methods]
Hemodynamics
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Patient Selection
Predictive Value of Tests
Proportional Hazards Models
Pulmonary Disease, Chronic Obstructive/di [Diagnosis]
Pulmonary Disease, Chronic Obstructive/mo [Mortality]
Retrospective Studies
Risk Assessment
Risk Factors
Spirometry
Time Factors
Treatment Outcome
Vital Capacity
MedStar Heart & Vascular Institute
Comparative Study
Journal Article