Diastolic Function and Clinical Outcomes After Transcatheter Aortic Valve Replacement: PARTNER 2 SAPIEN 3 Registry.
Citation: Journal of the American College of Cardiology. 76(25):2940-2951, 2020 12 22.PMID: 33334422Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Aortic Valve Stenosis | *Heart Failure, Diastolic | *Patient Readmission/sn [Statistics & Numerical Data] | *Postoperative Complications | *Transcatheter Aortic Valve Replacement/ae [Adverse Effects] | Aged, 80 and over | Aortic Valve Stenosis/mo [Mortality] | Aortic Valve Stenosis/pp [Physiopathology] | Aortic Valve Stenosis/su [Surgery] | Canada | Echocardiography/mt [Methods] | Echocardiography/sn [Statistics & Numerical Data] | Female | Heart Failure, Diastolic/di [Diagnosis] | Heart Failure, Diastolic/et [Etiology] | Heart Failure, Diastolic/pp [Physiopathology] | Humans | Male | Outcome and Process Assessment, Health Care | Postoperative Complications/di [Diagnosis] | Postoperative Complications/pp [Physiopathology] | Prognosis | Survival Analysis | Transcatheter Aortic Valve Replacement/mt [Methods] | United StatesYear: 2020Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:- 0735-1097
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 33334422 | Available | 33334422 |
Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
BACKGROUND: Few studies have evaluated if diastolic function could predict outcomes in patients with aortic stenosis.
CONCLUSIONS: In the PARTNER 2 SAPIEN 3 registry, baseline DD was a predictor of up to 2 years clinical outcomes in patients who underwent TAVR. Improvement in DD grade at 30 days was associated with improvement in short-term clinical outcomes. (The PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - PARTNER II - PARTNERII - S3 Intermediate [PARTNERII S3i]; NCT03222128; PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - High Risk and Nested Registry 7 [PII S3HR/NR7]; NCT03222141). Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
METHODS: Baseline, 30-day, and 1- and 2-year transthoracic echocardiograms from the PARTNER (Placement of Aortic Transcatheter Valves) 2 SAPIEN 3 registry were analyzed by a consortium of core laboratories and divided into the American Society of Echocardiography DD groups.
OBJECTIVES: The authors aimed to assess the association between diastolic dysfunction (DD) and outcomes in patients with aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).
RESULTS: Among the 1,750 included, 682 (54.4%) had grade 1 DD, 352 (28.1%) had grade 2 DD, 168 (13.4%) had grade 3 DD, and 51 (4.1%) had indeterminate DD grade. Incremental baseline grades of DD were associated with an increase in combined 1- and 2-year cardiovascular (CV) death/rehospitalization (all p < 0.002) and all-cause death at 2 years (p = 0.01) but not at 1 year. Improvement in DD grade/grade 1 DD at 30 days post-TAVR was seen in 70.8% patients. Patients with improvement in >=1 grade of DD/grade 1 DD had reduced 1-year CV death/rehospitalization (p < 0.001) and increased 2-year survival (p = 0.01). Baseline grade 3 DD was a predictor of 1-year CV death/rehospitalization (hazard ratio: 2.73; 95% confidence interval: 1.07 to 6.98; p = 0.04). Improvement in DD grade/grade 1 DD at 30 days was protective for 1-year CV death/rehospitalizations (hazard ratio: 0.39; 95% confidence interval: 0.19 to 0.83; p = 0.01).
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