Impact of Stroke Volume Index and Left Ventricular Ejection Fraction on Mortality After Aortic Valve Replacement

Ito, Saki; Nkomo, Vuyisile T.; Orsinelli, David A.; Lin, Grace; Cavalcante, João L.; Popma, Jeffrey J.; Adams, David H.; Checuti, Stanley J.; Deeb, G. Michael; Boulware, Michael J.; Huang, Jian; Little, Stephen H.; Cohen, Sidney A.; Reardon, Michael J.; Oh, Jae K.

doi:10.1016/j.mayocp.2019.10.031

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…In addition, as expected, age and left ventricular ejection fraction were also found to be related with mortality in our study, which was consistent with previous studies 17,18 . The difference of valve types between group 1 and 2 could be explained partially by age affecting valve selection.…”

Section: Discussionsupporting

confidence: 93%

“…However, other indices about ventricular repolarization, such as frontal QRS-T angle, was In addition, as expected, age and left ventricular ejection fraction were also found to be related with mortality in our study, which was consistent with previous studies. 17,18 The difference of valve types between group 1 and 2 could be explained partially by age affecting valve selection. Another distinctive finding in our study was less usage of ACEI or ARB in mortality group.…”

Section: Discussionmentioning

confidence: 99%

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Novel markers of ventricular repolarization are associated with mortality in patients undergoing surgical aortic valve replacement for severe aortic stenosis

Avcı

Demir

Bulut

et al. 2021

Journal of Cardiac Surgery

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Introduction: Aortic stenosis (AS) is the most common degenerative valvular heart disease that can affect left ventricular functions. Tp-e interval and Tp-e/QT ratio is a novel repolarization marker which is associated with adverse cardiovascular events in several cardiovascular diseases. In our study, our aim is to investigate the prognostic effect of Tp-e interval, Tp-e/QT and Tp-e/QTc ratios on mortality in patients who underwent successful surgical aortic valve replacement (AVR).Methods: A total of three hundred seventy-five patients undergoing successful surgical AVR were included in this study. Then, patients were divided into two groups according to mortality as group 1 without mortality (342 patients) and group 2 with mortality (33 patients). Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were calculated for both groups.Results: Tp-e interval (71 (63.7-77); 86 (84-88), p < .001), Tp-e/QT ratio (0.19 (0.17-0.20); 0.23 (0.22-0.23), p < .001) and Tp-e/QTc ratio (0.17 ± 0.02; 0.21 ± 0.01, p < .001) were higher in group 2 compared to group 1. In multivariate logistic regression analyses Tp-e interval (odds ratio [OR]: 1.315, 95% confidence interval [CI]:

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Novel markers of ventricular repolarization are associated with mortality in patients undergoing surgical aortic valve replacement for severe aortic stenosis

Avcı

Demir

Bulut

et al. 2021

Journal of Cardiac Surgery

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“…74 However, in other studies including 1 meta-analysis of 5,580 patients, TAVI with or without percutaneous coronary intervention did not appear to consistently affect 1-year mortality. 75 Similarly, in depressed left ventricular ejection fraction, 76 baseline diastolic dysfunction and lack of improvement of diastolic dysfunction, 77 atrial fibrillation, 78,79 a lack of improvement of baseline mitral regurgitation, 80 moderate or more tricuspid regurgitation, 81,82 right ventricular dysfunction, 83 and baseline renal dysfunction or post-procedural acute kidney injury are all associated with worse outcomes. 60 What all these studies demonstrate is that the presence of another major illness that is not related to AS (e.g., severe coronary artery disease) increases risk of mortality on long-term follow-up.…”

Section: Predictors Of Survivalmentioning

confidence: 99%

TAVI Beyond 3 Years: Durability and Predictors for Survival

Rahman

Resar

2021

Innovations�(Phila)

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The use of transcatheter aortic valve implantation (TAVI) has greatly increased over the past 2 decades and now has overtaken surgical aortic valve replacement. We have limited data regarding the long-term durability of TAVI and the predictors of survival. Calcification, inflammation, fibrous tissue deposition, and mechanical stress are important in the structural deterioration of surgical bioprosthetic valves and likely contribute to TAVI durability. However, TAVI has several differences to surgical valve replacement such as valve preparation, valve to native anatomy interaction, and valve sizing which all likely contribute to durability and long-term survival. Most procedures have been performed on older patients and therefore long-term follow-up studies have noted mortality of approximately 50% at 5 years and 75% by 7 years. Current data are limited by the high mortality of patients who have received TAVI often as a result of age, frailty, and other competing comorbidities. TAVI as compared with surgical valve replacement is associated with several differences including higher conduction abnormalities (i.e., need for pacemakers) and paravalvular leak, both of which may affect long-term morbidity and mortality. In this review, we discuss the current status of our knowledge and identify areas that require further investigation.

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“…On this background, two studies in this issue of the Mayo Clinic Proceedings have further enhanced our evolving understanding of intervention in AS, finding predictive parameters that have not been used by clinicians in the past. Ito et al 6 performed an analysis of the high-risk AS population that was randomized to TAVR or surgery, stratified by baseline myocardial pathology with a reduced ejection fraction or stroke volume. A low stroke volume was predictive of higher 1-year mortality, indicating that this measurement of ventricular function is important.…”

Section: Summary Of Current Studiesmentioning

confidence: 99%