The influence of aortic pulse wave velocity on short-term functional capacity in patients with mild paravalvular regurgitation following transcatheter aortic valve implantation
Rev. bras. cir. cardiovasc; 35 (4), 2020
Publication year: 2020
Abstract Introduction:
Recently, the clinical significance of mild paravalvular aortic regurgitation (PAR) has been evaluated and suggested that it can be predictor of clinical outcomes. In our study, we aimed to investigate the interaction of aortic pulse wave velocity (PWV) and mild PAR and their effects on the functional status of patients after transcatheter aortic valve implantation (TAVI).Methods:
A total of 109 consecutive patients with symptomatic severe aortic stenosis were enrolled prospectively. After TAVI procedure, they were divided in to three groups according to PAR and PWV measurements. Patients without PAR were defined as the NonePAR group (n=60), patients with mild PAR and normal PWV were defined as the MildPAR-nPWV group (n=23), and patients with mild PAR and high PWV were defined as the MildPAR-hPWV group (n=26).Results:
Compared with other groups, the MildPAR-hPWV group was older (P<0.001), hypertensive (P=0.015), and had a higher pulse pressure (P=0.018). In addition to PWV, this group had lower aortic regurgitation index (ARI) (P=0.010) and higher rate of New York Heart Association (NYHA) class II (at least) patients (P<0.001) in 30-day follow-up period. On multivariate regression analysis, the MildPARhPWV group (odds ratio=1.364, 95% confidence interval 1.221-1.843; P=0.011) as well as N-terminal-pro-brain natriuretic peptide levels and ARI were independently related with 30-day functional NYHA classification. However, NonePAR or MildPAR-nPWV group was not an independent predictor of early functional status.Conclusion:
It was concluded that high PWV may adversely affect early functional status in patients with mild PAR in contrast to normal values following TAVI.
Antagonistas de Receptores de Angiotensina, Inhibidores de la Enzima Convertidora de Angiotensina, Válvula Aórtica/cirugía, Estenosis de la Válvula Aórtica/cirugía, Prótesis Valvulares Cardíacas, Análisis de la Onda del Pulso, Índice de Severidad de la Enfermedad, Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos, Resultado del Tratamiento