Optimal stroke volume index cut off for survival of severe aortic stenosis patients undergoing TAVI - where should we draw the line?
نویسندگان
چکیده
Abstract Funding Acknowledgements Type of funding sources: None. Background Low-flow status in patients with severe aortic stenosis (SAS) is currently defined using stroke volume index (SVi), at a cut off below 35mL/m2. has been associated higher mortality undergoing transcatheter valve implantation (TAVI). However, different offs have recently suggested to more accurately define low-SVi worse survival after valvular intervention. Purpose Determine the impact SVi SAS TAVI and prognostically relevant threshold this context. Methods A database comprising all treated between 2011 2019 single-centre was retrospectively analyzed, cases echocardiograms performed before intervention our centre were included. Primary endpoint as time all-cause death or last follow-up over five years Surv_cutpoint from package R used evaluate optimal cutpoints TAVI. compared normal-flow counterparts determined definition. The prognostic values continuous categorical <35mL/m2 newly tested Kaplan-Meier curves, log-rank test Cox proportional hazard model adjusted for EuroSCORE II. Patients further divided having preserved reduced ejection fraction (EF, <52%). p<0.05 considered statistically significant. Results Of 657 performed, 488 (74.6%) included present analysis, median 56 months. SVi<35ml/m2 not (p = 0.07). An cutpoint <29mL/m2 (n=115, 24%), these on advanced NYHA class, estimated surgical risk, frequently hypertensive anemic, had prevalence atrial fibrillation. Echocardiographic data revealed lower EF, functional area transvalvular gradients patients. Regarding design, balloon-expandable setting. SVi<29ml/m2 [p 0.003, ratio (HR) 1.60 (1.18–2.17)], including adjusting II, (but preserved) EF When analyzed variable, better Conclusions parameter Contrary classically <35mL/m2, SVi<29mL/m2 population.
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Survival by stroke volume index in patients with low-gradient normal EF severe aortic stenosis.
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ژورنال
عنوان ژورنال: European Journal of Echocardiography
سال: 2023
ISSN: ['2047-2412', '2047-2404']
DOI: https://doi.org/10.1093/ehjci/jead119.179