Stroke volume index and transvalvular flow rate trajectories in severe aortic stenosis treated with TAVR.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gallone Guglielmo, Islas Fabian, Gorla Riccardo, Melillo Francesco, Leone Pier Pasquale, Cimaglia Paolo, Pastore Maria Concetta, Franzone Anna, Landra Federico, Bruno Francesco, Scudeler Luca, Jimenez-Quevedo Pilar, Viva Tommaso, Piroli Francesco, Bragato Renato, Trichilo Michele, Degiovanni Anna, Ilardi Federica, Andreis Alessandro, Nombela-Franco Luis, Maurizio Tusa, Toselli Marco, Conrotto Federico, Montorfano Matteo, Manzo Rachele, Cameli Matteo, Patti Giuseppe, Stefanini Giulio, Testa Luca, Giannini Francesco, Agricola Eustachio, Escaned Javier, D'Ascenzo Fabrizio, De Ferrari Gaetano M
Аннотация
METHODS AND RESULTS: Patients were categorized according to SVi (<35 mL/m2) and FR (<200 mL/s). The association of pre- and post-TAVR SVi and FR with all-cause mortality up to 3 years was assessed with multivariable Cox regression models. Among 980 patients with pre-TAVR flow assessment, SVi was reduced in 41.3% and FR in 48.1%. Baseline flow status was not an independent mortality predictor [SVi: hazard ratio (HR) 1.22, 95% confidence interval (CI) 0.85-1.82, FR: HR 0.78, 95% CI 0.48-1.27]. Among 731 patients undergoing early (5 days, interquartile range 2-29) post-TAVR flow assessment, SVi recovered in 40.1% and FR in 49.0% patients with baseline low flow. Reduced FR following TAVR was an independent predictor of mortality (HR 1.67, 95% CI 1.02-2.74), whereas SVi was not (HR 0.97, 95% CI 0.53-1.78). Three-year estimated mortality in patients with recovered FR was lower than that in patients with reduced FR (13.3 vs. 37.7% vs, P = 0.003) and similar to that in patients with normal baseline FR (P = 0.317).
CONCLUSION: Baseline flow status was not an independent predictor of mid-term mortality among all-comers with severe AS undergoing TAVR. Flow recovery early after TAVR was frequent. Post-TAVR FR, but not SVi, was independently associated with mid-term all-cause mortality. By impacting flow status, AV replacement modifies the association of flow status with outcomes.