Outcome of patients with heart failure after transcatheter aortic valve implantation

  • Aims: Patients with aortic stenosis (AS) may have concomitant heart failure (HF) that determines prognosis despite successful transcatheter aortic valve implantation (TAVI). We compared outcomes of TAVI patients with low stroke volume index (SVI) ≤35 ml/m2 body surface area in different HF classes. Methods and results: Patients treated by transfemoral TAVI at our center (n = 1822) were classified as 1) ‘HF with preserved ejection fraction (EF)’ (HFpEF, EF ≥50%), 2) ‘HF with mid-range EF’ (HFmrEF, EF 40–49%), or 3) ‘HF with reduced EF’ (HFrEF, EF <40%). Patients with SVI >35 ml/m2 served as controls. The prevalence of cardiovascular disease and symptoms increased stepwise from controls (n = 968) to patients with HFpEF (n = 591), HFmrEF (n = 97), and HFrEF (n = 166). Mortality tended to be highest in HFrEF patients 30 days post-procedure, and it became significant after one year: 10.2% (controls), 13.5% (HFpEF), 13.4% (HFmrEF), and 23.5% (HFrEF). However, symptomatic improvement in survivors of all groups was achieved in the majority of patients without differences among groups. Conclusions: Patients with AS and HF benefit from TAVI with respect to symptom alleviation. TAVI in patients with HFpEF and HFmrEF led to an identical, favorable post-procedural prognosis that was significantly better than that of patients with HFrEF, which remains a high-risk population.

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Author:Ulrich Fischer-Rasokat, Matthias Renker, Christoph Liebetrau, Maren Weferling, Andreas Rolf, Mirko Doss, Helge Möllmann, Thomas WaltherGND, Christian Hamm, Won-Keun Kim
URN:urn:nbn:de:hebis:30:3-517053
DOI:https://doi.org/10.1371/journal.pone.0225473d
ISSN:1932-6203
Parent Title (English):PLoS one
Publisher:PLoS
Place of publication:Lawrence, Kan.
Contributor(s):Gabor Erdös
Document Type:Article
Language:English
Year of Completion:2019
Date of first Publication:2019/11/26
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/11/27
Tag:Aortic valve; Blood pressure; Body mass index; Chronic obstructive pulmonary disease; Death rates; Ejection fraction; Heart failure; Prognosis
Volume:14
Issue:(11): e0225473
Page Number:13
First Page:1
Last Page:13
Note:
Copyright: © 2019 Fischer-Rasokat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
HeBIS-PPN:456404562
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0