Changes of Right Ventricular Function After Transcatheter Aortic Valve Replacement and Association With Outcomes.

Poch, Felix; Thalmann, Ruth; Olbrich, Ida; Fellner, Carmen; Stundl, Anja; Barthel, Petra; Bradaric, Christian; Laugwitz, Karl-Ludwig; Kupatt, Christian; Ledwoch, Jakob

doi:10.1016/j.cardfail.2021.03.007

2021

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Title:: Changes of Right Ventricular Function After Transcatheter Aortic Valve Replacement and Association With Outcomes.
Document type:: Article; Journal Article
Author(s):: Poch, Felix; Thalmann, Ruth; Olbrich, Ida; Fellner, Carmen; Stundl, Anja; Barthel, Petra; Bradaric, Christian; Laugwitz, Karl-Ludwig; Kupatt, Christian; Ledwoch, Jakob
Abstract:: BACKGROUND: Baseline right ventricular (RV) dysfunction represents a predictor for poor outcome in patients undergoing transcatheter aortic valve replacement (TAVR). However, RV function may improve after TAVR, which could have important implications on outcomes. The aim of the present study was to assess changes in RV function after TAVR and its prognostic value regarding clinical outcome. METHODS AND RESULTS: Patients undergoing TAVR at our institution were consecutively enrolled and categorized into 4 groups according to changes in RV function during echocardiographic follow-up at 6 months. A total of 188 patients were included. Of those showing normal function at baseline, 87% (130/149) had preserved RV function at follow-up (group 1), whereas 13% (19/149) developed new RV dysfunction (group 2). Of those with RV dysfunction at baseline (39 patients), RV function normalized in 46% (18/39) (group 3) and remained impaired in 54% (21/39) (group 4). The Kaplan-Meier estimated survival at 3 years was highest in patients in group 1 (83%), intermediate in group 2 (65%) and 3 (69%), whereas group 4 had the worst survival (37%; P < .001). Furthermore, new or persistent RV dysfunction was identified to be independently associated with mortality during follow-up (hazard ratio 2.55; interquartile range 1.03-6.47, P = .004). CONCLUSIONS: Patients with preserved RV function have a high 3-year survival. Normalization of RV function showed improved survival compared with patients with persistent RV dysfunction, who had a dismal prognosis despite TAVR.
Journal title abbreviation:: J Card Fail
Year:: 2021
Journal volume:: 27
Journal issue:: 12
Pages contribution:: 1337-1344
Fulltext / DOI:: doi:10.1016/j.cardfail.2021.03.007
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/33839289
Print-ISSN:: 1071-9164
TUM Institution:: Klinik und Poliklinik für Innere Medizin I, Kardiologie
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)2021