European heart journal. Cardiovascular Imaging · 2026
Cardiac damage and outcome in transcatheter aortic valve replacement patients-a COMPARE-TAVI 1 trial sub-study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Carter-Storch Rasmus, Terkelsen Christian Juhl, Nissen Henrik, Pedersen Anders Lehmann Dahl, Andersen Karen Juel, Frederiksen Christian Alcaraz, Haujir Amal, Ulrikkaholm Emil, Vase Henrik, Thim Troels, Freeman Philip, Uttenthal Frederik, Christiansen Ulrik, Christiansen Evald Høj, Dahl Jordi Sanchez
Аннотация
AIMS: This study aims to investigate the prognostic role of Stage 3 and 4 cardiac damage (CD) after transcatheter aortic valve intervention (TAVI), dependent on whether comorbidities contributing to right heart dysfunction were present.
METHODS AND RESULTS: Patients with severe aortic stenosis (AS) undergoing TAVI were included. Patients were divided into three groups: Stage 0-2 CD; Stage 3-4 CD, isolated AS (Stage 3-4 CD without significant concomitant chronic obstructive pulmonary disease, mitral annular calcification, mitral stenosis, mitral regurgitation, previous coronary artery bypass graft surgery, or cardiac amyloidosis); Stage 3-4 CD, AS with comorbidities (Stage 3-4 CD with ≥ 1 of these comorbidities). Futility was defined as death or Stage 3-4 New York Heart Association class dyspnoea 1 year after TAVI.Of 985 included patients, 822 (83%) had Stage 1-2 CD; 101 (10%) had Stage 3-4 CD, isolated AS; and 62 (6%) had Stage 3-4 CD, AS with comorbidities. Futility was not more common in Stage 3-4 CD groups (Stage 1-2 CD, 10%; Stage 3-4 CD, isolated AS, 17%; Stage 3-4 CD, AS with comorbidities, 15%, P = 0.09). Baseline and 1-year NYHA class were higher in Stage 3-4 CD compared with Stage 1-2 CD (P < 0.01). The 6 min walking test distance increased similarly in all groups at 1 year.
CONCLUSION: Potential comorbidities contributing to right heart dysfunction were common among patients in Stage 3-4 CD undergoing TAVI. Stage 3-4 CD was not associated with a significantly higher risk of futility, irrespective of comorbidities, and they experienced a similar functional improvement after TAVI.
METHODS AND RESULTS: Patients with severe aortic stenosis (AS) undergoing TAVI were included. Patients were divided into three groups: Stage 0-2 CD; Stage 3-4 CD, isolated AS (Stage 3-4 CD without significant concomitant chronic obstructive pulmonary disease, mitral annular calcification, mitral stenosis, mitral regurgitation, previous coronary artery bypass graft surgery, or cardiac amyloidosis); Stage 3-4 CD, AS with comorbidities (Stage 3-4 CD with ≥ 1 of these comorbidities). Futility was defined as death or Stage 3-4 New York Heart Association class dyspnoea 1 year after TAVI.Of 985 included patients, 822 (83%) had Stage 1-2 CD; 101 (10%) had Stage 3-4 CD, isolated AS; and 62 (6%) had Stage 3-4 CD, AS with comorbidities. Futility was not more common in Stage 3-4 CD groups (Stage 1-2 CD, 10%; Stage 3-4 CD, isolated AS, 17%; Stage 3-4 CD, AS with comorbidities, 15%, P = 0.09). Baseline and 1-year NYHA class were higher in Stage 3-4 CD compared with Stage 1-2 CD (P < 0.01). The 6 min walking test distance increased similarly in all groups at 1 year.
CONCLUSION: Potential comorbidities contributing to right heart dysfunction were common among patients in Stage 3-4 CD undergoing TAVI. Stage 3-4 CD was not associated with a significantly higher risk of futility, irrespective of comorbidities, and they experienced a similar functional improvement after TAVI.