Open AccessCalculated plasma volume status and outcomes in patients undergoing transcatheter aortic valve replacement
Author(s) -
Shimura Tetsuro,
Yamamoto Masanori,
Yamaguchi Ryo,
Adachi Yuya,
Sago Mitsuru,
Tsunaki Tatsuya,
Kagase Ai,
Koyama Yutaka,
Otsuka Toshiaki,
Yashima Fumiaki,
Tada Norio,
Naganuma Toru,
Yamawaki Masahiro,
Yamanaka Futoshi,
Shirai Shinichi,
Mizutani Kazuki,
Tabata Minoru,
Ueno Hiroshi,
Takagi Kensuke,
Watanabe Yusuke,
Hayashida Kentaro
Publication year - 2021
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.13270
Subject(s) - medicine , quartile , hazard ratio , cardiology , proportional hazards model , heart failure , valve replacement , multivariate analysis , confidence interval , stenosis
Aims This study investigated the prognostic value of plasma volume status (PVS) in patients who underwent transcatheter aortic valve replacement (TAVR). Methods and results Plasma volume status was calculated in 2588 patients who underwent TAVR using data from the Japanese multicentre registry. All‐cause mortality and heart failure hospitalization (HFH) within 2 years of TAVR were compared among the PVS quartiles (Q1, PVS < 5.5%; Q2, PVS 5.5–13.5%; Q3, PVS 13.5–21.0%; and Q4, PVS ≥ 21.0%). Subgroups were stratified by the PVS cut‐off value combined with the New York Heart Association (NYHA) class as follows: low PVS with NYHA I/II ( n = 959), low PVS with NYHA III/IV ( n = 845), high PVS with NYHA I/II ( n = 308), and high PVS with NYHA III/IV ( n = 476). The cumulative all‐cause mortality and HFH within 2 years of TAVR significantly increased with increasing PVS quartiles [8.5%, 16.8%, 19.2%, and 27.0% ( P < 0.001) and 5.8%, 8.7%, 10.3%, and 12.9% ( P < 0.001), respectively]. The high‐PVS group regardless of the NYHA class had a higher all‐cause mortality and HFH [9.6%, 18.2%, 24.5%, and 30.4% ( P < 0.001) and 6.1%, 10.4%, 14.1%, and 11.3% ( P < 0.001)]. In a Cox regression multivariate analysis, the PVS values of Q3 and Q4 had independently increased all‐cause mortality [hazard ratio (HR), 1.50 and 1.64 ( P = 0.017 and P = 0.008), respectively], and Q4 had independently increased HFH (HR, 1.98, P = 0.005). The low PVS with NYHA III/IV, high PVS with NYHA I/II, and high PVS with NYHA III/IV also had significantly increased all‐cause mortality [HR, 1.45, 1.73, and 1.86 ( P = 0.006, P = 0.002, and P < 0.001), respectively] and HFH [HR, 1.52, 2.21, and 1.70 ( P = 0.049, P = 0.002, and P = 0.031), respectively]. Conclusions Plasma volume status is useful for predicting all‐cause mortality and HFH after TAVR.