TY - JOUR
T1 - Paradoxical prognostic impact of severe aortic stenosis following trans-catheter aortic valve implantation
AU - Onoda, Hiroshi
AU - Imamura, Teruhiko
AU - Ueno, Hiroshi
AU - Oshima, Akira
AU - Ushijima, Ryuichi
AU - Sobajima, Mitsuo
AU - Kinugawa, Koichiro
N1 - Publisher Copyright:
© 2024 Elsevier Ltd
PY - 2024/11
Y1 - 2024/11
N2 - Background: Aortic valve replacement is recommended for patients with “very severe” aortic stenosis (AS), irrespective of symptomatic manifestation. Nonetheless, the prognostic ramifications of “very severe” AS, as opposed to “severe” AS, subsequent to trans-catheter aortic valve implantation (TAVI) remain enigmatic. Methods: We enrolled consecutive patients who received TAVI at our institute between May 2015 and April 2021. We scrutinized the impact of baseline “very severe” AS upon 3-year all-cause death or heart failure hospitalization following TAVI, in comparison to “severe” AS. Results: A total of 239 patients (84.8 ± 5.4 years old, 58 men) were included. Baseline “very severe” AS was observed in 65 (27 %) patients, who exhibited more advanced hypertrophy and higher B-type natriuretic peptide levels compared to those with “severe” AS (p < 0.05 for both). Baseline “very severe” AS was paradoxically associated with higher freedom from the primary endpoint following TAVI compared to those with “severe” AS (p = 0.01). Conclusions: The presence of baseline “very severe” AS was paradoxically associated with improved clinical outcomes subsequent to TAVI, in contrast to the cases of “severe” AS.
AB - Background: Aortic valve replacement is recommended for patients with “very severe” aortic stenosis (AS), irrespective of symptomatic manifestation. Nonetheless, the prognostic ramifications of “very severe” AS, as opposed to “severe” AS, subsequent to trans-catheter aortic valve implantation (TAVI) remain enigmatic. Methods: We enrolled consecutive patients who received TAVI at our institute between May 2015 and April 2021. We scrutinized the impact of baseline “very severe” AS upon 3-year all-cause death or heart failure hospitalization following TAVI, in comparison to “severe” AS. Results: A total of 239 patients (84.8 ± 5.4 years old, 58 men) were included. Baseline “very severe” AS was observed in 65 (27 %) patients, who exhibited more advanced hypertrophy and higher B-type natriuretic peptide levels compared to those with “severe” AS (p < 0.05 for both). Baseline “very severe” AS was paradoxically associated with higher freedom from the primary endpoint following TAVI compared to those with “severe” AS (p = 0.01). Conclusions: The presence of baseline “very severe” AS was paradoxically associated with improved clinical outcomes subsequent to TAVI, in contrast to the cases of “severe” AS.
KW - Aortic stenosis
KW - Transcatheter aortic valve implantation
KW - Very severe aortic stenosis
UR - http://www.scopus.com/inward/record.url?scp=85189794245&partnerID=8YFLogxK
U2 - 10.1016/j.jjcc.2024.03.010
DO - 10.1016/j.jjcc.2024.03.010
M3 - 学術論文
C2 - 38580175
AN - SCOPUS:85189794245
SN - 0914-5087
VL - 84
SP - 311
EP - 316
JO - Journal of Cardiology
JF - Journal of Cardiology
IS - 5
ER -