Publication
Transcatheter Aortic Valve Implantation Outcomes in Patients with Low Flow Low Gradient Aortic Stenosis
| dc.contributor.author | Castelo, A | |
| dc.contributor.author | Grazina, A | |
| dc.contributor.author | Mendonça, T | |
| dc.contributor.author | Rodrigues, I | |
| dc.contributor.author | Garcia Brás, P | |
| dc.contributor.author | Ferreira, V | |
| dc.contributor.author | Ramos, R | |
| dc.contributor.author | Fiarresga, A | |
| dc.contributor.author | Cacela, D | |
| dc.contributor.author | Cruz Ferreira, R | |
| dc.date.accessioned | 2023-06-29T14:41:50Z | |
| dc.date.available | 2023-06-29T14:41:50Z | |
| dc.date.issued | 2022-08 | |
| dc.description.abstract | Background: Some studies suggest that patients with low flow low gradient (LF-LG) aortic stenosis (AS) may achieve worse results after undergoing transcatheter aortic valve implantation (TAVI). Purpose: To compare outcomes between LF-LG AS and high gradient (HG) AS patients submitted to TAVI. Methods: Inclusion of 480 consecutive patients who underwent TAVI between 2008 and 2020 at a single tertiary center. Patients were divided into high gradient AS and LF-LG AS; and baseline characteristics and outcomes after the procedure were collected and compared between groups. Results: Patients with LF-LG AS had worse baseline characteristics, with higher Society of Thoracic Surgeons score (p=0.008), New Euroscore II (p<0.0001), and NT pro-natriuretic peptide B (p=0.001), more frequent left ventricular ejection fraction (LVEF) <40% (p<0.0001), coronary artery disease (p<0.0001), including previous myocardial infarction (p=0.002) and coronary artery bypass graft (p<0.0001), poor vascular accesses (p=0.026) and periprocedural angioplasty (p=0.038). In a multivariate analysis, adjusted to differences in baseline characteristics, LF-LG AS was associated with worse functional class at one year (p=0.023) and in the long-term (p=0.004) and with heart failure hospitalizations at one year and in the long-term (p=0.001 and p<0.0001). In a sub-analysis including only patients with LF-LG AS, those with LVEF <40% had the worst outcomes, with more global (p=0.035) and cardiovascular (p=0.038) mortality. Conclusion: Patients with LF-LG AS have worse short and long-term outcomes, even when adjusted for baseline characteristic differences. The sub-group of patients with LVEF <40% have the most ominous global outcomes. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Rev Port Cardiol. 2022;41(8):621-631. | pt_PT |
| dc.identifier.doi | 10.1016/j.repc.2022.03.002 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/4580 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier España | pt_PT |
| dc.subject | HSM CAR | pt_PT |
| dc.subject | Aortic Stenosis | pt_PT |
| dc.subject | Low Flow Low Gradient | pt_PT |
| dc.subject | Transcatheter Aortic Valve Implantation | pt_PT |
| dc.title | Transcatheter Aortic Valve Implantation Outcomes in Patients with Low Flow Low Gradient Aortic Stenosis | pt_PT |
| dc.title.alternative | Resultados da Implantação de Válvula Aórtica por Via Percutânea em Doentes com Estenose Aórtica com Baixo Fluxo-Baixo Gradiente | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 631 | pt_PT |
| oaire.citation.issue | 8 | pt_PT |
| oaire.citation.startPage | 621 | pt_PT |
| oaire.citation.title | Revista Portuguesa de Cardiologia | pt_PT |
| oaire.citation.volume | 41 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |