| Title |
Dynamic changes in aortic impedance after transcatheter aortic valve replacement and its impact on exploratory outcome
|
|---|---|
| Published in |
The International Journal of Cardiovascular Imaging, May 2017
|
| DOI | 10.1007/s10554-017-1155-6 |
| Pubmed ID | |
| Authors |
Yukari Kobayashi, Juyong B. Kim, Kegan J. Moneghetti, Yuhei Kobayashi, Ran Zhang, Daniel A. Brenner, Ryan O’Malley, Ingela Schnittger, Michael Fischbein, D. Craig Miller, Alan C. Yeung, David Liang, Francois Haddad, William F. Fearon |
| Abstract |
Valvulo-arterial impedance (Zva) has been shown to predict worse outcome in medically managed aortic stenosis (AS) patients. We aimed to investigate the association between Zva and left ventricular (LV) adaptation and to explore the predictive value of Zva for cardiac functional recovery and outcome after transcatheter aortic valve replacement (TAVR). We prospectively enrolled 128 patients with AS who underwent TAVR. Zva was calculated as: (systolic blood pressure + mean transaortic gradient)/stroke volume index). Echocardiographic assessment occurred at baseline, 1-month and 1-year after TAVR. The primary endpoints were to investigate associations between Zva and global longitudinal strain (GLS) at baseline as well as GLS change after TAVR. The secondary was to compare all-cause mortality after TAVR between patients with pre-defined Zva (=5 mmHg m(2)/ml), stroke volume index (=35 ml/m(2)), and GLS (=-15%) cutoffs. The mean GLS was reduced (-13.0 ± 3.2%). The mean Zva was 5.2 ± 1.6 mmHg*m(2)/ml with 55% of values ≥5.0 mmHg*m(2)/ml, considered to be abnormally high. Higher Zva correlated with worse GLS (r = -0.33, p < 0.001). After TAVR, Zva decreased significantly (5.1 ± 1.6 vs. 4.5 ± 1.6 mmHg*m(2)/ml, p = 0.001). A reduction of Zva at 1-month was associated with GLS improvement at 1-month (r = -0.31, p = 0.001) and at 1-year (r = -0.36 and p = 0.001). By Kaplan-Meier analysis, patients with higher Zva at baseline had higher mortality (Log-rank p = 0.046), while stroke volume index and GLS did not differentiate outcome (Log-rank p = 0.09 and 0.25, respectively). As a conclusion, Zva is correlated with GLS in AS as well as GLS improvement after TAVR. Furthermore, a high baseline Zva may have an additional impact to traditional parameters on predicting worse mortality after TAVR. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 24 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 24 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 3 | 13% |
| Student > Doctoral Student | 2 | 8% |
| Other | 2 | 8% |
| Student > Bachelor | 2 | 8% |
| Student > Ph. D. Student | 2 | 8% |
| Other | 4 | 17% |
| Unknown | 9 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 46% |
| Sports and Recreations | 1 | 4% |
| Unknown | 12 | 50% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 May 2017.
All research outputs
#22,777,327
of 25,394,764 outputs
Outputs from The International Journal of Cardiovascular Imaging
#1,460
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Outputs of similar age
#286,449
of 327,234 outputs
Outputs of similar age from The International Journal of Cardiovascular Imaging
#56
of 66 outputs
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