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Risk assessment in patients with left ventricular systolic dysfunction following transcatheter aortic valve replacement
Author(s) -
Imamura Teruhiko,
Ueno Hiroshi,
Sobajima Mitsuo,
Kinugawa Koichiro,
Watanabe Yusuke,
Yashima Fumiaki,
Tada Norio,
Naganuma Toru,
Yamawaki Masahiro,
Yamanaka Futoshi,
Shirai Shinichi,
Mizutani Kazuki,
Tabata Minoru,
Takagi Kensuke,
Yamamoto Masanori,
Hayashida Kentaro
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15822
Subject(s) - medicine , cardiology , ejection fraction , valve replacement , regurgitation (circulation) , hazard ratio , stenosis , heart failure , confidence interval , aortic valve stenosis
Background Mortality following transcatheter aortic valve replacement (TAVR) in patients with post‐procedural left ventricular systolic dysfunction remains high. We investigated clinical variables associating with worse clinical outcomes following TAVR in patients with systolic dysfunction. Methods We retrospectively investigated 2588 patients with severe aortic stenosis who received TAVR and were enrolled in the optimized transcatheter valvular intervention (OCEAN‐TAVI) multicenter registry (UMIN000020423). The association between the clinical variables following TAVR and 2‐year cardiovascular mortality was investigated among those with post‐TAVR left ventricular ejection fraction less than 50%. Results A total of 298 patients (median 85 years old, 131 men) were included. The presence of moderate or greater tricuspid regurgitation following TAVR was independently associated with 2‐year mortality (adjusted hazard ratio 3.41, 95% confidence interval 1.15–10.1), and significantly discriminated 2‐year cardiovascular mortality (30% vs. 12%, p = 0.001). No patients with any improvement in tricuspid regurgitation had cardiovascular death. Conclusion Following TAVR, the existence of significant tricuspid regurgitation was associated with cardiovascular mortality in patients with heart failure with reduced ejection fraction.