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A novel echocardiographic hemodynamic index for predicting outcome of aortic stenosis patients following transcatheter aortic valve replacement
Yousef Altayyeb
Hibbert Benjamin
Feder Joshua
Bernick Jordan
Russo Juan
MacDonald Zachary
Glover Christopher
Dick Alexander
Boodhwani Munir
Buu Khanh Lam
Ruel Marc
Labinaz Marino
Burwash Ian G
PLos One, 2018, 13(4): e0195641.
Summary
Objective
Transcatheter aortic valve replacement (TAVR) reduces left ventricular (LV) afterload and improves prognosis in aortic stenosis (AS) patients. However, LV afterload consists of both valvular and arterial loads, and the benefits of TAVR may be attenuated if the arterial load dominates. We proposed a new hemodynamic index, the Relative Valve Load (RVL), a ratio of mean gradient (MG) and valvuloarterial impedance (Zva), to describe the relative contribution of the valvular load to the global LV load, and examined whether RVL predicted patient outcome following TAVR.
Methods
A total of 258 patients with symptomatic severe AS (indexed aortic valve area (AVA) <0.6cm(2)/m(2), AR Results
There were 53 deaths (20.5%) at 1-year. RVL 0.75cm(2), % SWL 5mmHg/ml/m(2) despite equivalent or better sensitivity. In multivariable Cox analysis, RVL Conclusions
RVL is a strong predictor of all-cause mortality in severe AS patients undergoing TAVR. A pre-procedural RVL
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