TY - JOUR
T1 - Association Between Diastolic Dysfunction and Health Status Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement
AU - Malik, Ali O.
AU - Omer, Mohamed
AU - Pflederer, Mathew C.
AU - Almomani, Ahmed
AU - Gosch, Kensey L.
AU - Jones, Philip G.
AU - Peri-Okonny, Poghni A.
AU - Al Badarin, Firas
AU - Brandt, Hunter A.
AU - Arnold, Suzanne V.
AU - Main, Michael L.
AU - Cohen, David J.
AU - Spertus, John A.
AU - Chhatriwalla, Adnan K.
N1 - Funding Information:
Drs. Malik, Peri-Okonny, and Al Badarin are supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award T32HL110837. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Arnold is supported by a Career Development Grant Award (K23 HL116799) from the National Heart, Lung, and Blood Institute of the National Institutes of Health. Dr. Main has received research grants from Lantheus Medical Imaging, GE Healthcare, and Bracco. Dr. Cohen has received research grant support from Edwards Lifesciences, Medtronic, Boston Scientific, and Abbott; and has received consulting fees from Medtronic and Edwards Lifesciences. Dr. Spertus owns the copyright for the Kansas City Cardiomyopathy Questionnaire; has equity interest in Health Outcomes Sciences; has received consulting income from Novartis, Bayer, AstraZeneca, V-Wave, Corvia, and Janssen; has served on the advisory board for United Healthcare; and has served on the board of directors for Blue Cross Blue Shield of Kansas City. Dr. Chhatriwalla is on the Speakers Bureau for and has received travel reimbursement from Medtronic, Edwards Lifesciences, and Abbott Vascular; and has been a proctor for Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2019 American College of Cardiology Foundation
PY - 2019/12/23
Y1 - 2019/12/23
N2 - Objectives: The aim of this study was to assess the association of baseline left ventricular diastolic dysfunction (LVDD) with health status outcomes of patients undergoing transcatheter aortic valve replacement (TAVR). Background: Although LVDD in patients with aortic stenosis is associated with higher mortality after TAVR, it is unknown if it is also associated with health status recovery. Methods: In a cohort of 304 patients with interpretable echocardiograms, undergoing TAVR, LVDD was categorized at baseline as absent (grade 0), mild (grade 1), moderate (grade 2), or severe (grade 3). Disease-specific health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OS) at baseline and at 1-month and 12-month follow-up. Association of baseline LVDD with health status at baseline and follow-up after TAVR was assessed using a linear trend test, and association with health status recovery (change in KCCQ-OS) was examined using a linear mixed model adjusting for baseline KCCQ-OS. Results: Twenty-four (7.9%), 54 (17.8%), 186 (61.2%), and 40 (13.2%) patients had LVDD grades of 0, 1, 2, and 3, respectively. Baseline KCCQ-OS was 61.3 ± 22.7, 51.0 ± 26.1, 44.7 ± 25.7, and 44.4 ± 21.9 (p = 0.004) in patients with LVDD grades of 0, 1,2 and 3. At 1 and 12 months after TAVR, LVDD was not associated with KCCQ-OS. Recovery in KCCQ-OS after TAVR was substantial and similar in patients across all severities of LVDD. Conclusions: Although LVDD is associated with health status prior to TAVR, patients across all severities of LVDD have similar recovery in health status after TAVR.
AB - Objectives: The aim of this study was to assess the association of baseline left ventricular diastolic dysfunction (LVDD) with health status outcomes of patients undergoing transcatheter aortic valve replacement (TAVR). Background: Although LVDD in patients with aortic stenosis is associated with higher mortality after TAVR, it is unknown if it is also associated with health status recovery. Methods: In a cohort of 304 patients with interpretable echocardiograms, undergoing TAVR, LVDD was categorized at baseline as absent (grade 0), mild (grade 1), moderate (grade 2), or severe (grade 3). Disease-specific health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OS) at baseline and at 1-month and 12-month follow-up. Association of baseline LVDD with health status at baseline and follow-up after TAVR was assessed using a linear trend test, and association with health status recovery (change in KCCQ-OS) was examined using a linear mixed model adjusting for baseline KCCQ-OS. Results: Twenty-four (7.9%), 54 (17.8%), 186 (61.2%), and 40 (13.2%) patients had LVDD grades of 0, 1, 2, and 3, respectively. Baseline KCCQ-OS was 61.3 ± 22.7, 51.0 ± 26.1, 44.7 ± 25.7, and 44.4 ± 21.9 (p = 0.004) in patients with LVDD grades of 0, 1,2 and 3. At 1 and 12 months after TAVR, LVDD was not associated with KCCQ-OS. Recovery in KCCQ-OS after TAVR was substantial and similar in patients across all severities of LVDD. Conclusions: Although LVDD is associated with health status prior to TAVR, patients across all severities of LVDD have similar recovery in health status after TAVR.
KW - health status
KW - left ventricular diastolic dysfunction
KW - transcatheter aortic valve replacement
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U2 - 10.1016/j.jcin.2019.08.036
DO - 10.1016/j.jcin.2019.08.036
M3 - Article
C2 - 31786216
AN - SCOPUS:85076012071
VL - 12
SP - 2476
EP - 2484
JO - JACC. Cardiovascular interventions
JF - JACC. Cardiovascular interventions
SN - 1936-8798
IS - 24
ER -