151. Extent of Cardiac Damage and Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation
- Author
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Roberta Esposito, Anna Franzone, Luigi Di Serafino, Cristina Iapicca, Giovanni Esposito, Domenico Simone Castiello, Andrea Mariani, Attilio Leone, Federica Ilardi, Ciro Santoro, Marisa Avvedimento, Plinio Cirillo, Maria Scalamogna, Domenico Angellotti, Raffaele Piccolo, Avvedimento, M., Franzone, A., Leone, A., Piccolo, R., Castiello, D. S., Ilardi, F., Mariani, A., Esposito, R., Iapicca, C., Angellotti, D., Scalamogna, M., Santoro, C., Di Serafino, L., Cirillo, P., and Esposito, G.
- Subjects
medicine.medical_specialty ,Tricuspid valve ,business.industry ,Mortality rate ,Diastole ,General Medicine ,staging ,medicine.disease ,mortality ,Article ,Stenosis ,medicine.anatomical_structure ,Internal medicine ,Mitral valve ,medicine ,Cardiology ,Risk of mortality ,cardiovascular system ,Medicine ,cardiac damage ,Myocardial infarction ,Stage (cooking) ,business ,transcatheter aortic valve implantation - Abstract
(1) Aims: We sought to assess the impact of the extent of cardiac damage on survival among real-world patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). (2) Methods: A staging classification was applied to 262 patients from the EffecTAVI Registry at baseline and re-assessed within 30-days after TAVI. The primary endpoint of the study was all-cause mortality at 1-year. Secondary endpoints included cerebrovascular accident, myocardial infarction, permanent pacemaker implantation, endocarditis, and re-hospitalization for all causes. (3) Results: At baseline, 23 (8.7%) patients were in Stage 0/1 (no cardiac damage/left ventricular damage), 106 (40.4%) in Stage 2 (left atrial or mitral valve damage), 59 (22.5%) in Stage 3 (pulmonary vasculature or tricuspid valve damage) and 74 (28.3%) in Stage 4 (right ventricular damage). At 30-days after TAVI, a lower prevalence of advanced stages of cardiac damage than baseline, mainly driven by a significant improvement in left ventricular diastolic parameters and right ventricular function, was reported. At 1-year, a stepwise increase in mortality rates was observed according to staging at baseline: 4.3% in Stage 0/1, 6.6% in Stage 2, 18.6% in Stage 3 and 21.6% in Stage 4 (p = 0.08). No differences were found in secondary endpoints. (4) Conclusions: TAVI has an early beneficial impact on the left ventricular diastolic and right ventricular function. However, the extent of cardiac damage at baseline significantly affects the risk of mortality at 1-year after the procedure.
- Published
- 2021