Echocardiographic parameters associated with less reverse left ventricular remodeling after transcatheter aortic valve implant in subjects with prosthesis patient mismatch.

Background: Transaortic valve implant (TAVI) is the treatment of choice for severe aortic stenosis (AS). Some patients develop prosthesis patient mismatch (PPM) after TAVI. It is challenging to determine which patients are at risk for clinical deterioration. Methods: We retrospectively measured echo...

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Publicado en:Echocardiography Vol. 41; no. 1; pp. 1 - 11
Autores principales: Peters, Andrew C., Gong, Fei Fei, Ramesh, Ashvita, Andrei, Adin, Jankowski, Madeline, Cantey, Eric, Chen, Vincent, Thomas, James D., Flaherty, James D., Malaisrie, S. Christopher, Maganti, Kameswari
Formato: diagnostic images research tables/charts Journal Article
Publicado: Wiley-Blackwell Jan2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2024
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      pub: Wiley-Blackwell
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        10.1111/echo.15698
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        atl: Echocardiographic parameters associated with less reverse left ventricular remodeling after transcatheter aortic valve implant in subjects with prosthesis patient mismatch.
      aug:
        au:
          Peters, Andrew C.
          Gong, Fei Fei
          Ramesh, Ashvita
          Andrei, Adin
          Jankowski, Madeline
          Cantey, Eric
          Chen, Vincent
          Thomas, James D.
          Flaherty, James D.
          Malaisrie, S. Christopher
          Maganti, Kameswari
        affil: Northwestern University Feinberg School of Medicine, Chicago, USA
      sug:
        subj:
          Aortic Valve Stenosis Surgery
          Transcatheter Aortic Valve Implantation Adverse Effects
          Ventricular Function, Left Physiology
          Ventricular Remodeling
          Echocardiography
          Heart Valve Prosthesis Utilization
          Treatment Outcomes
          Geriatric Functional Assessment
          Human
          Male
          Female
          Aged
          Aged, 80 and Over
          Retrospective Design
          Aortic Valve Insufficiency
          Descriptive Statistics
          Comparative Studies
          Aortic Valve Stenosis Ultrasonography
          Correlation Coefficient
          Data Analysis Software
          Clinical Assessment Tools
          Functional Status
          Survival Rate
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background: Transaortic valve implant (TAVI) is the treatment of choice for severe aortic stenosis (AS). Some patients develop prosthesis patient mismatch (PPM) after TAVI. It is challenging to determine which patients are at risk for clinical deterioration. Methods: We retrospectively measured echocardiographic parameters of left ventricular (LV) morphology and function, prosthetic aortic valve effective orifice area (iEOA) and hemodynamics in 313 patients before and 1 year after TAVI. Our objective was to compare the change in echocardiographic parameters associated with left ventricular reverse modeling in subjects with and without PPM. Our secondary objective was to evaluate echo parameters associated with PPM and the relationship to patient functional status and survival post‐TAVI. Results: We found that 82 (26.2%) of subjects had moderate and 37 (11.8%) had severe PPM post‐TAVI. There was less relative improvement in LVEF with PPM (1.9 ± 21.3% vs. 8.2 + 30.1%, p =.045). LV GLS also exhibited less relative improvement in those with PPM (13.4 + 34.1% vs. 30.9 + 73.3%, p =.012). NYHA functional class improved in 84.3% of subjects by one grade or more. Echocardiographic markers of PPM were worse in those without improvement in NYHA class (mean AT/ET was.29 vs..27, p =.05; DVI was.46 vs..51, p =.021; and iEOA was.8 cm/m2 vs..9 cm/m2, p =.025). There was no association with PPM and survival. Conclusions: There was no improvement in LVEF and less improvement in LV GLS in those with PPM post‐TAVI. Echocardiographic markers of PPM were present in those with lack of improvement in NYHA functional class.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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