TY  - BOOK
AU  - Weissman, Neil J
TI  - Diastolic Function and Clinical Outcomes After Transcatheter Aortic Valve Replacement: PARTNER 2 SAPIEN 3 Registry
SN  - 0735-1097
PY  - 2020///
KW  - *Aortic Valve Stenosis
KW  - *Heart Failure, Diastolic
KW  - *Patient Readmission/sn [Statistics & Numerical Data]
KW  - *Postoperative Complications
KW  - *Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/mo [Mortality]
KW  - Aortic Valve Stenosis/pp [Physiopathology]
KW  - Aortic Valve Stenosis/su [Surgery]
KW  - Canada
KW  - Echocardiography/mt [Methods]
KW  - Echocardiography/sn [Statistics & Numerical Data]
KW  - Female
KW  - Heart Failure, Diastolic/di [Diagnosis]
KW  - Heart Failure, Diastolic/et [Etiology]
KW  - Heart Failure, Diastolic/pp [Physiopathology]
KW  - Humans
KW  - Male
KW  - Outcome and Process Assessment, Health Care
KW  - Postoperative Complications/di [Diagnosis]
KW  - Postoperative Complications/pp [Physiopathology]
KW  - Prognosis
KW  - Survival Analysis
KW  - Transcatheter Aortic Valve Replacement/mt [Methods]
KW  - United States
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
N2  - 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)
UR  - https://dx.doi.org/10.1016/j.jacc.2020.10.032
ER  -