TY  - BOOK
AU  - Asch, Federico M
AU  - Ben-Dor, Itsik
AU  - Didier, Romain
AU  - Goldstein, Steven A
AU  - Jerusalem, Zack
AU  - Kiramijyan, Starkis
AU  - Koifman, Edward
AU  - Medvedofsky, Diego
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Torguson, Rebecca
AU  - Waksman, Ron
AU  - Wang, Zuyue
AU  - Xu, Linzhi
TI  - Impact of Baseline Left Ventricular Diastolic Dysfunction in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation
SN  - 0002-9149
PY  - 2020///
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Aortic Valve/su [Surgery]
KW  - *Echocardiography/mt [Methods]
KW  - *Heart Valve Prosthesis
KW  - *Heart Ventricles/dg [Diagnostic Imaging]
KW  - *Transcatheter Aortic Valve Replacement/mt [Methods]
KW  - *Ventricular Dysfunction, Left/pp [Physiopathology]
KW  - *Ventricular Function, Left/ph [Physiology]
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/co [Complications]
KW  - Aortic Valve Stenosis/di [Diagnosis]
KW  - Aortic Valve/dg [Diagnostic Imaging]
KW  - Diastole
KW  - District of Columbia/ep [Epidemiology]
KW  - Female
KW  - Follow-Up Studies
KW  - Heart Ventricles/pp [Physiopathology]
KW  - Humans
KW  - Incidence
KW  - Male
KW  - Preoperative Period
KW  - Prognosis
KW  - Retrospective Studies
KW  - Severity of Illness Index
KW  - Survival Rate/td [Trends]
KW  - Ventricular Dysfunction, Left/di [Diagnosis]
KW  - Ventricular Dysfunction, Left/ep [Epidemiology]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N2  - We sought to assess the impact of diastolic dysfunction (DD) grade, as per the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines, on survival of patients with severe aortic stenosis (AS) who underwent transcatheter aortic valve implantation (TAVI). We included consecutive patients with severe AS who underwent TAVI in our institution. DD grading was determined retrospectively according to the 2016 ASE DD guidelines and categorized to grade I-III and indeterminate grade I-II DD. Comparison of 1-year survival according to DD grade was performed by Kaplan-Meier analysis, and evaluation of DD at 1 year was performed in a subset of patients. Among 606 TAVI patients, 394 (65%) had sufficient data for DD grading. Seventy-seven (20%) had grade I DD, 191 (48%) had grade II, 60 (15%) had grade III, and 66 (17%) had an indeterminate grade between I and II. Baseline characteristics indicate higher rates of atrial fibrillation, brain natriuretic peptide level, pulmonary artery systolic pressure, and indexed left ventricular mass as DD grade increases (all p <=0.01). In conclusion, comparison of 1-year survival revealed a higher rate of mortality in patients with grade III DD that remained statistically significant following adjustment in a multivariate Cox proportional hazard model. DD grade after TAVI improved in patients with grades II and III. Severe AS patients with grade III DD have higher risk for 1-year mortality after TAVI compared with milder degrees of DD. Further research is warranted to explore a potential benefit for aortic valve therapy at an earlier stage of the disease process. Copyright (c) 2019 Elsevier Inc. All rights reserved
UR  - https://dx.doi.org/10.1016/j.amjcard.2019.10.016
ER  -