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1. Left Ventricular Hypertrophy in Aortic Stenosis: Early Cell and Matrix Regression 2 Months Post-Aortic Valve Replacement

Author

Bennett, Jonathan, Thornton, George D., Nitsche, Christian, Gama, Francisco F., Aziminia, Nikoo, Gul, Uzma, Shetye, Abhishek, Kellman, Peter, Davies, Rhodri H., Moon, James C., Treibel, Thomas A., Adams, Benjamin, Ambekar, Shirish, Aktuerk, Dincer, Awad, Wael, Baumbach, Andreas, Bhattacharyya, Sanjeev, Di Salvo, Carmelo, Kolvekar, Shyamsunder, Lall, Kulvinder, Lawrence, David, Lopez-Marco, Miss Ana, Lloyd, Guy, Kennon, Simon, Manisty, Charlotte, Mathur, Anthony, Mravljak, Rok, Mullen, Michael, Oo, Aung, Ozkor, Mick, Pierce, Iain, Roberts, Neil, Sheikh, Amir, Shipolini, Alex, Uppal, Rakesh, Wong, Phooi Kit, Yates, Martin, and Yap, John

Published
2024
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7. Identifying Cardiac Amyloid in Aortic Stenosis: ECV Quantification by CT in TAVR Patients

Author

Scully, Paul R., Patel, Kush P., Saberwal, Bunny, Klotz, Ernst, Augusto, João B., Thornton, George D., Hughes, Rebecca K., Manisty, Charlotte, Lloyd, Guy, Newton, James D., Sabharwal, Nikant, Kelion, Andrew, Kennon, Simon, Ozkor, Muhiddin, Mullen, Michael, Hartman, Neil, Cavalcante, João L., Menezes, Leon J., Hawkins, Philip N., Treibel, Thomas A., Moon, James C., and Pugliese, Francesca

Published
2020
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8. DPD Quantification in Cardiac Amyloidosis: A Novel Imaging Biomarker

Author

Scully, Paul R., Morris, Elizabeth, Patel, Kush P., Treibel, Thomas A., Burniston, Maria, Klotz, Ernst, Newton, James D., Sabharwal, Nikant, Kelion, Andrew, Manisty, Charlotte, Kennon, Simon, Ozkor, Muhiddin, Mullen, Michael, Hartman, Neil, Elliott, Perry M., Pugliese, Francesca, Hawkins, Philip N., Moon, James C., and Menezes, Leon J.

Published
2020
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10. Aortic valve and left ventricular outflow tract calcium volume and distribution in transcatheter aortic valve replacement: Influence on the risk of significant paravalvular regurgitation

Author

Hansson, Nicolaj C., Leipsic, Jonathon, Pugliese, Francesca, Andersen, Henning R., Rossi, Alexia, Simonato, Matheus, Jensen, Kaare T., Christiansen, Evald H., Terkelsen, Christian J., Blanke, Philipp, Tang, Mariann, Krusell, Lars R., Klaaborg, Kaj-Erik, Terp, Kim, Kennon, Simon, Dvir, Danny, Bøtker, Hans Erik, Webb, John, and Nørgaard, Bjarne L.

Published
2018
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12. Contrast Volume-to-Estimated Glomerular Filtration Rate Ratio as a Predictor of Short-Term Outcomes Following Transcatheter Aortic Valve Implantation.

Author

Chehab, Omar, Esposito, Giulia, Long, Edouard J. B., Ng Yin Ling, Clarissa, Hale, Samuel, Malomo, Samuel, O'Reilly, Nanci, Mathur, Anthony, Baumbach, Andreas, Ozkor, Mick, Kennon, Simon, and Mullen, Michael

Subjects
HEART valve prosthesis implantation, GLOMERULAR filtration rate, ACUTE kidney failure, LOGISTIC regression analysis, CONTRAST media
Abstract

Background/Objectives: Contrast-induced acute kidney injury (AKI) is associated with early mortality and adverse events. However, in the setting of transcatheter aortic valve implantation (TAVI), previous literature has failed to establish a correlation between the absolute volume of contrast media administered and mortality. We aimed to investigate the impact of contrast volume administered normalised to estimated glomerular filtration rate (CV/eGFR) on the development of AKI and on 30-day all-cause mortality in TAVI patients. Methods: We retrospectively analysed a cohort of 1150 patients who underwent TAVI at our unit between 2015 and 2018. Results: Follow-up was complete for 1064 patients. There were 23 deaths within the follow-up period and 76 cases of AKI, 9 of which required new renal replacement therapy (RRT). Receiver-operating characteristic (ROC) curve analysis showed fair discrimination for 30-day all-cause mortality at a CV/eGFR ratio of 3.6 (area under the ROC curve (AUC) 0.671). Of patients in whom CV data were available, 86.0% (n = 757) had a CV/eGFR < 3.6 and 14.0% (n = 123) had a CV/eGFR ≥ 3.6. In multivariate logistic regression analysis, CV/eGFR ≥ 3.6 was the strongest predictor of 30-day all-cause mortality (odds ratio 5.06, 95% confidence interval [1.61–15.7], p = 0.004). Other independent predictors were procedural urgency (3.28 [1.04–10.3], p = 0.038) and being under general anaesthesia (4.81 [1.10–17.3], p = 0.023). CV/eGFR ≥ 3.6 was also independently associated with significantly increased odds of AKI (2.28 [1.20–4.17], p = 0.009) alongside significant non-left main stem coronary artery disease (2.56 [1.45–4.66], p = 0.001), and diabetes (1.82 [1.03–3.19], p = 0.037). In supplementary ROC curve analysis, a similar CV/eGFR cut point of 3.6 was found to be an excellent predictor for new RRT (AUC 0.833). Conclusions: In conclusion, a CV/eGFR ≥ 3.6 post-TAVI was found to be a strong predictor of 30-day mortality and AKI. The maximum contrast volume that can be safely administered in each patient without significantly increasing the risk of mortality and AKI can be calculated using this ratio. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Quality of Life Measures in Aortic Stenosis Research:A Narrative Review

Author

Frank, Derk, Kennon, Simon, Bonaros, Nikolaos, Romano, Mauro, Di Mario, Carlo, Van Ginkel, Dirk Jan, Bor, Wilbert, Kasel, Markus, Backer, Ole De, Hachaturyan, Violetta, Lüske, Claudia M., Kurucova, Jana, Bramlage, Peter, Styra, Rima, Frank, Derk, Kennon, Simon, Bonaros, Nikolaos, Romano, Mauro, Di Mario, Carlo, Van Ginkel, Dirk Jan, Bor, Wilbert, Kasel, Markus, Backer, Ole De, Hachaturyan, Violetta, Lüske, Claudia M., Kurucova, Jana, Bramlage, Peter, and Styra, Rima

Abstract

Background: Elderly patients with aortic stenosis (AS) not only have a reduced life expectancy but also a reduced quality of life (QoL). The benefits of an AS intervention may be considered a balance between a good QoL and a reasonably extended life. However, the different questionnaires being used to determine the QoL were generally not developed for the specific situation of patients with AS and come with strengths and considerable weaknesses. The objective of this article was to provide an overview of the available QoL instruments in AS research, describe their strengths and weaknesses, and provide our assessment of the utility of the available scoring instruments for QoL measurements in AS. Summary: We identified and reviewed the following instruments that are used in AS research: Short Form Health Survey (SF-36/SF-12), EuroQol-5D (EQ-5D), the Illness Intrusiveness Rating Scale (IIRS), the HeartQoL, the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Minnesota Living with Heart Failure Questionnaire (MLHF), the MacNew Questionnaire, and the Toronto Aortic Stenosis Quality of Life Questionnaire (TASQ). Key Messages: There is no standardized assessment of QoL in patients with AS. Many different questionnaires are being used, but they are rarely specific for AS. There is a need for AS-specific research into the QoL of patients as life prolongation may compete for an improved QoL in this elderly patient group.

Published
2023

16. Quality of Life Measures in Aortic Stenosis Research: A Narrative Review

Author

Frank, Derk, Kennon, Simon, Bonaros, Nikolaos, Romano, Mauro, Di Mario, Carlo, van Ginkel, Dirk-Jan, Bor, Wilbert, Kasel, Markus; https://orcid.org/0000-0002-1090-9213, De Backer, Ole, Hachaturyan, Violetta, Lüske, Claudia M, Kurucova, Jana, Bramlage, Peter, Styra, Rima, Frank, Derk, Kennon, Simon, Bonaros, Nikolaos, Romano, Mauro, Di Mario, Carlo, van Ginkel, Dirk-Jan, Bor, Wilbert, Kasel, Markus; https://orcid.org/0000-0002-1090-9213, De Backer, Ole, Hachaturyan, Violetta, Lüske, Claudia M, Kurucova, Jana, Bramlage, Peter, and Styra, Rima

Abstract

BACKGROUND Elderly patients with aortic stenosis (AS) not only have a reduced life expectancy but also a reduced quality of life (QoL). The benefits of an AS intervention may be considered a balance between a good QoL and a reasonably extended life. However, the different questionnaires being used to determine the QoL were generally not developed for the specific situation of patients with AS and come with strengths and considerable weaknesses. The objective of this article was to provide an overview of the available QoL instruments in AS research, describe their strengths and weaknesses, and provide our assessment of the utility of the available scoring instruments for QoL measurements in AS. SUMMARY We identified and reviewed the following instruments that are used in AS research: Short Form Health Survey (SF-36/SF-12), EuroQol-5D (EQ-5D), the Illness Intrusiveness Rating Scale (IIRS), the HeartQoL, the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Minnesota Living with Heart Failure Questionnaire (MLHF), the MacNew Questionnaire, and the Toronto Aortic Stenosis Quality of Life Questionnaire (TASQ). KEY MESSAGES There is no standardized assessment of QoL in patients with AS. Many different questionnaires are being used, but they are rarely specific for AS. There is a need for AS-specific research into the QoL of patients as life prolongation may compete for an improved QoL in this elderly patient group.

Published
2023

17. Quality of Life Measures in Aortic Stenosis Research: A Narrative Review

Author

Frank, Derk, primary, Kennon, Simon, additional, Bonaros, Nikolaos, additional, Romano, Mauro, additional, Di Mario, Carlo, additional, van Ginkel, Dirk-Jan, additional, Bor, Wilbert, additional, Kasel, Markus, additional, Backer, Ole De, additional, Hachaturyan, Violetta, additional, Lüske, Claudia M., additional, Kurucova, Jana, additional, Bramlage, Peter, additional, and Styra, Rima, additional

Published
2023
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21. Predictors of post-TAVI conduction abnormalities in patients with bicuspid aortic valves

Author

Esposito, Giulia, primary, Kumar, Niraj, additional, Pugliese, Francesca, additional, Sayers, Max, additional, Chow, Anthony WC, additional, Kennon, Simon, additional, Ozkor, Mick, additional, Mathur, Anthony, additional, Baumbach, Andreas, additional, Lloyd, Guy, additional, Mullen, Aigerim, additional, Cook, Andrew, additional, Mullen, Michael, additional, and Patel, Kush P, additional

Published
2022
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22. Effect of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement on All-Cause Mortality in Patients With Aortic Stenosis: A Randomized Clinical Trial

Author

Toff, William D., Hildick-Smith, David, Kovac, Jan, Mullen, Michael J., Wendler, Olaf, Mansouri, Anita, Rombach, Ines, Abrams, Keith R., Conroy, Simon P., Flather, Marcus D., Gray, Alastair M., MacCarthy, Philip, Monaghan, Mark J., Prendergast, Bernard, Ray, Simon, Young, Christopher P., Crossman, David C., Cleland, John G. F., de Belder, Mark A., Ludman, Peter F., Jones, Stephen, Densem, Cameron G., Tsui, Steven, Kuduvalli, Manoj, Mills, Joseph D., Banning, Adrian P., Sayeed, Rana, Hasan, Ragheb, Fraser, Douglas G. W., Trivedi, Uday, Davies, Simon W., Duncan, Alison, Curzen, Nick, Ohri, Sunil K., Malkin, Christopher J., Kaul, Pankaj, Muir, Douglas F., Owens, W. Andrew, Uren, Neal G., Pessotto, Renzo, Kennon, Simon, Awad, Wael I., Khogali, Saib S., Matuszewski, Maciej, Edwards, Richard J., Ramesh, Bandigowdanapalya C., Dalby, Miles, Raja, Shahzad G., Mariscalco, Giovanni, Lloyd, Clinton, Cox, Ian D., Redwood, Simon R., Gunning, Mark G., and Ridley, Paul D.

Subjects
Aged, 80 and over, Heart Valve Prosthesis Implantation, Male, Aortic Valve Insufficiency, General Medicine, Aortic Valve Stenosis, Transcatheter Aortic Valve Replacement, Treatment Outcome, Risk Factors, Aortic Valve, Heart Valve Prosthesis, Humans, Female, Aged, Original Investigation
Abstract

IMPORTANCE: Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical aortic valve replacement and is the treatment of choice for patients at high operative risk. The role of TAVI in patients at lower risk is unclear. OBJECTIVE: To determine whether TAVI is noninferior to surgery in patients at moderately increased operative risk. DESIGN, SETTING, AND PARTICIPANTS: In this randomized clinical trial conducted at 34 UK centers, 913 patients aged 70 years or older with severe, symptomatic aortic stenosis and moderately increased operative risk due to age or comorbidity were enrolled between April 2014 and April 2018 and followed up through April 2019. INTERVENTIONS: TAVI using any valve with a CE mark (indicating conformity of the valve with all legal and safety requirements for sale throughout the European Economic Area) and any access route (n = 458) or surgical aortic valve replacement (surgery; n = 455). MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality at 1 year. The primary hypothesis was that TAVI was noninferior to surgery, with a noninferiority margin of 5% for the upper limit of the 1-sided 97.5% CI for the absolute between-group difference in mortality. There were 36 secondary outcomes (30 reported herein), including duration of hospital stay, major bleeding events, vascular complications, conduction disturbance requiring pacemaker implantation, and aortic regurgitation. RESULTS: Among 913 patients randomized (median age, 81 years [IQR, 78 to 84 years]; 424 [46%] were female; median Society of Thoracic Surgeons mortality risk score, 2.6% [IQR, 2.0% to 3.4%]), 912 (99.9%) completed follow-up and were included in the noninferiority analysis. At 1 year, there were 21 deaths (4.6%) in the TAVI group and 30 deaths (6.6%) in the surgery group, with an adjusted absolute risk difference of −2.0% (1-sided 97.5% CI, −∞ to 1.2%; P

Published
2022

24. Rapid Assessment and Treatment In Decompensated Aortic Stenosis (ASTRID-AS study)- A pilot study

Author

Patel, Kush P, Mukhopadhyay, Sumanto, Bedford, Kerry, Richards, Rhian, Queenan, Helen, Jerrum, Melanie, Banton, Judy, Ozkor, Mick, Mathur, Anthony, Kennon, Simon, Baumbach, Andreas, and Mullen, Michael J

Abstract

Graphical AbstractSummary of the ASsessment and TReatment In Decompensated Aortic Stenosis (ASTRID-AS) study. A dedicated pathway, ASTRID-AS, reduced time to TAVI and hospital length of stay in patients with acute decompensated aortic stenosis. There was also a non-significant trend towards lower all-cause mortality and acute kidney injury. The vector image of the heart was obtained from www.vecteezy.com.

Published
2023
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25. Early pacemaker implantation for transcatheter aortic valve implantation is safe and effective

Author

Patel, Kush P, primary, Lim, Wei Yao, additional, Pavithran, Asha, additional, Assadi, Rangeena, additional, Wan, Daniel, additional, Kennon, Simon, additional, Ozkor, Mick, additional, Earley, Mark, additional, Sporton, Simon, additional, Dhinoja, Mehul, additional, Hayward, Carl, additional, Muthumala, Amal, additional, Hunter, Ross, additional, Lowe, Martin, additional, Lambiase, Pier, additional, Segal, Oliver, additional, Mathur, Anthony, additional, Schilling, Richard, additional, Baumbach, Andreas, additional, Mullen, Michael J, additional, and Chow, Anthony WC, additional

Published
2021
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26. Abstract 9418: Contrast Volume to Estimated Glomerular Filtration Rate Ratio as a Predictor for 30-Day All-Cause Mortality After Transcatheter Aortic Valve Implantation

Author

Chehab, Omar, primary, Ng Yin Ling, Clarissa, additional, Hale, Samuel, additional, Malomo, Samuel, additional, Berner, Juliet C, additional, O'Reilly, Nanci, additional, Mathur, Anthony, additional, Baumbach, Andreas, additional, Ozkor, Mick, additional, Kennon, Simon, additional, and Mullen, Michael, additional

Published
2021
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27. Quality of life after transcatheter or surgical aortic valve replacement using the Toronto Aortic Stenosis Quality of Life Questionnaire

Author

Kennon, Simon, primary, Styra, Rima, additional, Bonaros, Nikolaos, additional, Stastny, Lukas, additional, Romano, Mauro, additional, Lefèvre, Thierry, additional, Di Mario, Carlo, additional, Stefàno, Pierluigi, additional, Ribichini, Flavio Luciano, additional, Himbert, Dominique, additional, Urena-Alcazar, Marina, additional, Salgado-Fernandez, Jorge, additional, Cuenca Castillo, Jose Joaquin, additional, Garcia, Bruno, additional, Deutsch, Cornelia, additional, Sykorova, Lenka, additional, Kurucova, Jana, additional, Thoenes, Martin, additional, Lüske, Claudia, additional, Bramlage, Peter, additional, and Frank, Derk, additional

Published
2021
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28. Impact of afterload and infiltration on coexisting aortic stenosis and transthyretin amyloidosis

Author

Patel, Kush P, primary, Scully, Paul Richard, additional, Nitsche, Christian, additional, Kammerlander, Andreas A, additional, Joy, George, additional, Thornton, George, additional, Hughes, Rebecca, additional, Williams, Suzanne, additional, Tillin, Therese, additional, Captur, Gabriella, additional, Chacko, Liza, additional, Kelion, Andrew, additional, Sabharwal, Nikant, additional, Newton, James D, additional, Kennon, Simon, additional, Ozkor, Mick, additional, Mullen, Michael, additional, Hawkins, Philip N, additional, Gillmore, Julian D, additional, Menezes, Leon, additional, Pugliese, Francesca, additional, Hughes, Alun D, additional, Fontana, Marianna, additional, Lloyd, Guy, additional, Treibel, Thomas A, additional, Mascherbauer, Julia, additional, and Moon, James C, additional

Published
2021
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33. Non-implant valve repair for calcific aortic stenosis: the Leaflex study

Author

Baumbach, Andreas, primary, Mylotte, Darren, additional, Hildick-Smith, David, additional, Kennon, Simon, additional, Jonas, Michael, additional, Bartus, Krzysztof, additional, Trebacz, Jaroslaw, additional, Halevi, Rotem, additional, Kislev, Yael, additional, Plotnikov, Lena, additional, and Andreka, Peter, additional

Published
2021
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34. Prevalence and Outcomes of Concomitant Aortic Stenosis and Cardiac Amyloidosis

Author

Nitsche, Christian, primary, Scully, Paul R., additional, Patel, Kush P., additional, Kammerlander, Andreas A., additional, Koschutnik, Matthias, additional, Dona, Carolina, additional, Wollenweber, Tim, additional, Ahmed, Nida, additional, Thornton, George D., additional, Kelion, Andrew D., additional, Sabharwal, Nikant, additional, Newton, James D., additional, Ozkor, Muhiddin, additional, Kennon, Simon, additional, Mullen, Michael, additional, Lloyd, Guy, additional, Fontana, Marianna, additional, Hawkins, Philip N., additional, Pugliese, Francesca, additional, Menezes, Leon J., additional, Moon, James C., additional, Mascherbauer, Julia, additional, and Treibel, Thomas A., additional

Published
2021
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36. Aortic valve replacement: validation of the Toronto Aortic Stenosis Quality of Life Questionnaire

Author

Frank, Derk, primary, Kennon, Simon, additional, Bonaros, Nikolaos, additional, Stastny, Lukas, additional, Romano, Mauro, additional, Lefèvre, Thierry, additional, Di Mario, Carlo, additional, Stefàno, Pierluigi, additional, Ribichini, Flavio, additional, Himbert, Dominique, additional, Urena‐Alcazar, Marina, additional, Salgado‐Fernandez, Jorge, additional, Castillo, Jose Joaquin Cuenca, additional, Garcia del Blanco, Bruno, additional, Deutsch, Cornelia, additional, Sykorova, Lenka, additional, Kurucova, Jana, additional, Thoenes, Martin, additional, Lüske, Claudia M., additional, Bramlage, Peter, additional, and Styra, Rima, additional

Published
2020
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38. Prevalence and outcome of dual aortic stenosis and cardiac amyloid pathology in patients referred for transcatheter aortic valve implantation

Author

Scully, Paul R, primary, Patel, Kush P, additional, Treibel, Thomas A, additional, Thornton, George D, additional, Hughes, Rebecca K, additional, Chadalavada, Sucharitha, additional, Katsoulis, Michail, additional, Hartman, Neil, additional, Fontana, Marianna, additional, Pugliese, Francesca, additional, Sabharwal, Nikant, additional, Newton, James D, additional, Kelion, Andrew, additional, Ozkor, Muhiddin, additional, Kennon, Simon, additional, Mullen, Michael, additional, Lloyd, Guy, additional, Menezes, Leon J, additional, Hawkins, Philip N, additional, and Moon, James C, additional

Published
2020
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40. Early pacemaker implantation for transcatheter aortic valve implantation is safe and effective.

Author

Patel, Kush P, Lim, Wei Yao, Pavithran, Asha, Assadi, Rangeena, Wan, Daniel, Kennon, Simon, Ozkor, Mick, Earley, Mark, Sporton, Simon, Dhinoja, Mehul, Hayward, Carl, Muthumala, Amal, Hunter, Ross, Lowe, Martin, Lambiase, Pier, Segal, Oliver, Mathur, Anthony, Schilling, Richard, Baumbach, Andreas, and Mullen, Michael J

Subjects
PREVENTION of surgical complications, LENGTH of stay in hospitals, PREOPERATIVE care, HEART valve prosthesis implantation, SCIENTIFIC observation, HEMATOMA, TIME, MULTIVARIATE analysis, AORTIC stenosis, SURGICAL complications, POSTOPERATIVE care, SURGERY, PATIENTS, RETROSPECTIVE studies, CARDIAC pacing, HEART block, TREATMENT effectiveness, PRE-tests & post-tests, INFECTION, COMPARATIVE studies, DESCRIPTIVE statistics, CARDIAC pacemakers, EARLY medical intervention, COMPLICATIONS of prosthesis, EVALUATION
Abstract

Background: Permanent pacemaker (PPM) implantation is a common complication of transcatheter aortic valve implantation (TAVI). The optimum timing of PPM implantation is still unclear as conduction abnormalities evolve and a balance needs to be struck between conservative delays in the hope of conduction recovery and overutilization of pacing. This study aimed to assess the safety and efficacy of early PPM implantation, without an observation period, among TAVI patients. Methods: This is a retrospective, observational study of 1398 TAVI patients. Clinical and pacing data were collected at baseline, 30 days and at a median of 15 (4–21) months post‐TAVI. Study endpoints included PPM‐related complications, pacing utilization and hospital length of stay. Results: One hundred five patients (8.2%) required a PPM, of which 13 were implanted pre and 92 post‐TAVI. Seventy‐six percent required pacing for either second‐ or third‐degree heart block. Time to implantation for post‐TAVI PPM was 1 (0–3) day. Six patients experienced a pacing‐related complication‐ lead displacement (n = 3), hematoma (n = 2), and device infection (n = 1). Pacing utilization defined as pacing >10% of the time or a pacing requirement at the time of the pacing check was demonstrated in 83% of patients. Multivariate analysis revealed complete heart block (CHB) was the only independent predictor of pacing utilization. Hospital length of stay for the post‐TAVI PPM group was longer than the group without PPM (4 [2–8] vs. 3 [2–4] days; p <.001). Conclusions: Early PPM implantation in TAVI patients is safe and majority of patients require pacing in the short and mid‐term. [ABSTRACT FROM AUTHOR]

Published
2022
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41. Impact of afterload and infiltration on coexisting aortic stenosis and transthyretin amyloidosis.

Author

Patel, Kush P., Scully, Paul Richard, Nitsche, Christian, Kammerlander, Andreas A., Joy, George, Thornton, George, Hughes, Rebecca, Williams, Suzanne, Tillin, Therese, Captur, Gabriella, Chacko, Liza, Kelion, Andrew, Sabharwal, Nikant, Newton, James D., Kennon, Simon, Ozkor, Mick, Mullen, Michael, Hawkins, Philip N., Gillmore, Julian D., and Menezes, Leon

Subjects
CARDIAC amyloidosis, AORTIC stenosis, TRANSTHYRETIN, AMYLOIDOSIS, IMMUNOGLOBULIN light chains
Abstract

Objective: The coexistence of wild-type transthyretin cardiac amyloidosis (ATTR) is common in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). However, the impact of ATTR and AS on the resultant AS-ATTR is unclear and poses diagnostic and management challenges. We therefore used a multicohort approach to evaluate myocardial structure, function, stress and damage by assessing age-related, afterload-related and amyloid-related remodelling on the resultant AS-ATTR phenotype.Methods: We compared four samples (n=583): 359 patients with AS, 107 with ATTR (97% Perugini grade 2), 36 with AS-ATTR (92% Perugini grade 2) and 81 age-matched and ethnicity-matched controls. 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) scintigraphy was used to diagnose amyloidosis (Perugini grade 1 was excluded). The primary end-point was NT-pro Brain Natriuretic Peptide (BNP) and secondary end-points related to myocardial structure, function and damage.Results: Compared with older age controls, the three disease cohorts had greater cardiac remodelling, worse function and elevated NT-proBNP/high-sensitivity Troponin-T (hsTnT). NT-proBNP was higher in AS-ATTR (2844 (1745, 4635) ng/dL) compared with AS (1294 (1077, 1554)ng/dL; p=0.002) and not significantly different to ATTR (3272 (2552, 4197) ng/dL; p=0.63). Diastology, hsTnT and prevalence of carpal tunnel syndrome were statistically similar between AS-ATTR and ATTR and higher than AS. The left ventricular mass indexed in AS-ATTR was lower than ATTR (139 (112, 167) vs 180 (167, 194) g; p=0.013) and non-significantly different to AS (120 (109, 130) g; p=0.179).Conclusions: The AS-ATTR phenotype likely reflects an early stage of amyloid infiltration, but the combined insult resembles ATTR. Even after treatment of AS, ATTR-specific therapy is therefore likely to be beneficial. [ABSTRACT FROM AUTHOR]

Published
2022
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42. Foreword

Author

Kennon, Simon

Subjects
RD1-811, RC666-701, Diseases of the circulatory (Cardiovascular) system, Foreword, Surgery
Published
2019

45. Trial protocol for the validation of the ‘Toronto Aortic Stenosis Quality of Life (TASQ) Questionnaire’ in patients undergoing surgical aortic valve replacement (SAVR) or transfemoral (TF) transcatheter aortic valve implantation (TAVI): the TASQ registry

Author

Frank, Derk, primary, Kennon, Simon, additional, Bonaros, Nikolaos, additional, Romano, Mauro, additional, Lefèvre, Thierry, additional, Di Mario, Carlo, additional, Stefàno, Pierluigi, additional, Ribichini, Flavio Luciano, additional, Himbert, Dominique, additional, Urena-Alcazar, Marina, additional, Salgado-Fernandez, Jorge, additional, Cuenca Castillo, Jose Joaquin, additional, Garcia, Bruno, additional, Kurucova, Jana, additional, Thoenes, Martin, additional, Lüske, Claudia, additional, Bramlage, Peter, additional, and Styra, Rima, additional

Published
2019
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47. The evolution of device technology in transcatheter aortic valve implantation

Author

Bourantas, Christos V, Modolo, Rodrigo, Baumbach, Andreas, Søndergaard, Lars, Prendergast, Bernard D, Ozkor, Muhidin, Kennon, Simon, Mathur, Anthony, Mullen, Michael J, Serruys, Patrick W, Bourantas, Christos V, Modolo, Rodrigo, Baumbach, Andreas, Søndergaard, Lars, Prendergast, Bernard D, Ozkor, Muhidin, Kennon, Simon, Mathur, Anthony, Mullen, Michael J, and Serruys, Patrick W

Abstract

Transcatheter aortic valve implantation (TAVI) has rapidly evolved and changed the landscape of structural interventional cardiology. Advances in transcatheter heart valve (THV) prostheses and TAVI-enabling devices have simplified the procedure, reduced the risk of complications, improved short- and long-term outcomes and broadened the applications of TAVI, not only in challenging patients and complex anatomies but also in intermediate-risk or even in low-risk patients, where surgical valve replacement constitutes an effective and well-established therapy. In this review article, we provide an overview of the developments in TAVI devices which have played a vital role in TAVI evolution: we describe the prostheses that failed to reach clinical practice, we present the characteristics of the first valves that were tested in the clinical arena, we summarise the evidence from the first studies that highlighted the potential but also the limitations of TAVI, and we present the advanced next-generation THV prostheses that have an improved performance and safety profile.

Published
2019

48. Expert Opinion: Guidelines for the Management of Patients with Aortic Stenosis Undergoing Non-cardiac Surgery: Out of Date and Overly Prescriptive

Author

Kennon, Simon and Archbold, Andrew

Subjects
Structural, cardiovascular system
Abstract

Patients with severe aortic stenosis who require non-cardiac surgery present a difficult clinical problem. The most recent clinical practice guidelines from the American College of Cardiology/American Heart Association and the European Society of Cardiology for the perioperative cardiovascular assessment and management of patients undergoing noncardiac surgery were both published in 2014. These guidelines are reviewed in the light of recently published randomised controlled trial data regarding the efficacy of transcatheter aortic valve implantation to treat aortic stenosis.

Published
2017

49. Long-Term Durability of Transcatheter Aortic Valve Prostheses

Author

Blackman, Daniel J., primary, Saraf, Smriti, additional, MacCarthy, Philip A., additional, Myat, Aung, additional, Anderson, Simon G., additional, Malkin, Christopher J., additional, Cunnington, Michael S., additional, Somers, Kathryn, additional, Brennan, Paul, additional, Manoharan, Ganesh, additional, Parker, Jessica, additional, Aldalati, Omar, additional, Brecker, Stephen J., additional, Dowling, Cameron, additional, Hoole, Stephen P., additional, Dorman, Stephen, additional, Mullen, Michael, additional, Kennon, Simon, additional, Jerrum, Melanie, additional, Chandrala, Pavan, additional, Roberts, David H., additional, Tay, Justin, additional, Doshi, Sagar N., additional, Ludman, Peter F., additional, Fairbairn, Timothy A., additional, Crowe, Joanne, additional, Levy, Richard D., additional, Banning, Adrian P., additional, Ruparelia, Neil, additional, Spence, Mark S., additional, and Hildick-Smith, David, additional

Published
2019
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50. Aortic valve replacement: validation of the Toronto Aortic Stenosis Quality of Life Questionnaire.

Author

Frank, Derk, Kennon, Simon, Bonaros, Nikolaos, Stastny, Lukas, Romano, Mauro, Lefèvre, Thierry, Di Mario, Carlo, Stefàno, Pierluigi, Ribichini, Flavio, Himbert, Dominique, Urena‐Alcazar, Marina, Salgado‐Fernandez, Jorge, Castillo, Jose Joaquin Cuenca, Garcia del Blanco, Bruno, Deutsch, Cornelia, Sykorova, Lenka, Kurucova, Jana, Thoenes, Martin, Lüske, Claudia M., and Bramlage, Peter

Subjects
AORTIC stenosis, AORTIC valve transplantation, QUALITY of life
Abstract

Aims: There is no quality of life tool specifically developed for patients with severe aortic stenosis (AS) to assess how this chronic condition and its treatment affect patients. The Toronto Aortic Stenosis Quality of Life Questionnaire (TASQ) has been developed to overcome this gap. The results of the validation of the TASQ in patients undergoing treatment for severe AS are presented. Methods and results: Prospective study at 10 centres in Europe and Canada, which enrolled 274 patients with severe symptomatic AS undergoing surgical or transcatheter aortic valve replacement. Mean TASQ score at baseline was 71.2 points and increased to 88.9 three months after aortic valve implantation (P < 0.001). Increases were seen for the emotional impact (32.0 to 39.0; P < 0.001), physical limitations (14.8 to 22.0; P < 0.001), and physical symptoms (8.5 vs. 11.0; P < 0.001) domains. Internal consistency was good/excellent for overall TASQ score (α = 0.891) and for the physical limitation, emotional impact, and social limitation domains (α = 0.815–0.950). Test–retest reliability was excellent or strong for the overall TASQ (intraclass correlation coefficient of 0.883) and for the physical symptoms, physical limitation, emotional impact, and social limitation domains (intraclass correlation coefficient of 0.791–0.895). Responsiveness was medium overall (Cohen's d = 0.637) and medium/large for physical symptoms, emotional impact, and physical limitations (0.661–0.812). Sensitivity to change was significant for physical symptoms, physical limitations (both P < 0.001), emotional impact (P = 0.003), and social limitations (P = 0.038). Conclusions: The TASQ is a new, brief, self‐administered, and clinically relevant health‐specific tool to measure changes in quality of life in patients with AS undergoing an intervention. [ABSTRACT FROM AUTHOR]

Published
2021
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