Clinical impact of baseline mitral regurgitation on outcomes after transcatheter aortic valve replacement for severe aortic stenosis

Objective: The clinical impact of baseline mitral regurgitation (MR) on the outcomes after transcatheter aortic valve replacement (TAVR) is not clear. This study sought to assess the clinical impact of baseline MR on outcomes after TAVR. Methods: The study was a retrospective analysis. Data was from...

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Main Authors: Hua-Jie Zheng, Xin Liu, De-Qing Lin, Yong-Bo Cheng, Chao-Jun Yan, Jun Li, Wei Cheng
Format: Article
Language:English
Published: Elsevier 2024-02-01
Series:International Journal of Cardiology: Heart & Vasculature
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352906724000149
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author Hua-Jie Zheng
Xin Liu
De-Qing Lin
Yong-Bo Cheng
Chao-Jun Yan
Jun Li
Wei Cheng
author_facet Hua-Jie Zheng
Xin Liu
De-Qing Lin
Yong-Bo Cheng
Chao-Jun Yan
Jun Li
Wei Cheng
author_sort Hua-Jie Zheng
collection DOAJ
description Objective: The clinical impact of baseline mitral regurgitation (MR) on the outcomes after transcatheter aortic valve replacement (TAVR) is not clear. This study sought to assess the clinical impact of baseline MR on outcomes after TAVR. Methods: The study was a retrospective analysis. Data was from 120 consecutive patients with severe aortic stenosis (AS) undergoing TAVR at our center from June 2018 and July 2020. Clinical outcomes were assessed at 30-day, 1- and 2-year follow-up. Results: The median follow-up was 736.0 (interquartile range, 666.0–965.0) days. Overall survival in patients with nonsignificant and significant baseline MR was not significantly different, while patients from the improved MR group after TAVR demonstrated a significantly higher survival than unchanged or worsened MR group during 2-year follow-up. NYHA functional class had generally improved at 1 year, with only 8.3 % of patients with nonsignificant MR and 17.5 % of patients with significant MR in class III or IV. Patients with improved MR at 1 year after TAVR had a significantly higher LVEF, smaller LVEDD and LVESD than those with unchanged or worsened MR. Among the significant baseline MR group, 70.4 % and 80.0 % of patients had improved to nonsignificant MR at 30-day and 1-year follow-up after TAVR, respectively. Conclusions: Significant baseline MR was not associated with the increased risk of all-cause mortality 2 years after TAVR. Significant baseline MR was improved in most patients at 1 year after TAVR. Patients with unchanged or worsened MR had an increased all-cause mortality.
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spelling doaj.art-6085e364020e42b29bac39345769f1422024-02-21T05:29:05ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672024-02-0150101348Clinical impact of baseline mitral regurgitation on outcomes after transcatheter aortic valve replacement for severe aortic stenosisHua-Jie Zheng0Xin Liu1De-Qing Lin2Yong-Bo Cheng3Chao-Jun Yan4Jun Li5Wei Cheng6Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaDepartment of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaCorresponding authors at: Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan Road, Shapingba District, Chongqing 400038, China.; Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaCorresponding authors at: Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan Road, Shapingba District, Chongqing 400038, China.; Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, ChinaObjective: The clinical impact of baseline mitral regurgitation (MR) on the outcomes after transcatheter aortic valve replacement (TAVR) is not clear. This study sought to assess the clinical impact of baseline MR on outcomes after TAVR. Methods: The study was a retrospective analysis. Data was from 120 consecutive patients with severe aortic stenosis (AS) undergoing TAVR at our center from June 2018 and July 2020. Clinical outcomes were assessed at 30-day, 1- and 2-year follow-up. Results: The median follow-up was 736.0 (interquartile range, 666.0–965.0) days. Overall survival in patients with nonsignificant and significant baseline MR was not significantly different, while patients from the improved MR group after TAVR demonstrated a significantly higher survival than unchanged or worsened MR group during 2-year follow-up. NYHA functional class had generally improved at 1 year, with only 8.3 % of patients with nonsignificant MR and 17.5 % of patients with significant MR in class III or IV. Patients with improved MR at 1 year after TAVR had a significantly higher LVEF, smaller LVEDD and LVESD than those with unchanged or worsened MR. Among the significant baseline MR group, 70.4 % and 80.0 % of patients had improved to nonsignificant MR at 30-day and 1-year follow-up after TAVR, respectively. Conclusions: Significant baseline MR was not associated with the increased risk of all-cause mortality 2 years after TAVR. Significant baseline MR was improved in most patients at 1 year after TAVR. Patients with unchanged or worsened MR had an increased all-cause mortality.http://www.sciencedirect.com/science/article/pii/S2352906724000149Aortic stenosisTranscatheter aortic valve replacementMitral regurgitationClinical outcomeFollow-up
spellingShingle Hua-Jie Zheng
Xin Liu
De-Qing Lin
Yong-Bo Cheng
Chao-Jun Yan
Jun Li
Wei Cheng
Clinical impact of baseline mitral regurgitation on outcomes after transcatheter aortic valve replacement for severe aortic stenosis
International Journal of Cardiology: Heart & Vasculature
Aortic stenosis
Transcatheter aortic valve replacement
Mitral regurgitation
Clinical outcome
Follow-up
title Clinical impact of baseline mitral regurgitation on outcomes after transcatheter aortic valve replacement for severe aortic stenosis
title_full Clinical impact of baseline mitral regurgitation on outcomes after transcatheter aortic valve replacement for severe aortic stenosis
title_fullStr Clinical impact of baseline mitral regurgitation on outcomes after transcatheter aortic valve replacement for severe aortic stenosis
title_full_unstemmed Clinical impact of baseline mitral regurgitation on outcomes after transcatheter aortic valve replacement for severe aortic stenosis
title_short Clinical impact of baseline mitral regurgitation on outcomes after transcatheter aortic valve replacement for severe aortic stenosis
title_sort clinical impact of baseline mitral regurgitation on outcomes after transcatheter aortic valve replacement for severe aortic stenosis
topic Aortic stenosis
Transcatheter aortic valve replacement
Mitral regurgitation
Clinical outcome
Follow-up
url http://www.sciencedirect.com/science/article/pii/S2352906724000149
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