High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry
Mean Gradient (MG) elevation can be detected immediately after transcatheter aortic valve implantation (TAVI) or secondarily during follow-up. Comparisons and interactions between these two parameters and their impact on outcomes have not previously been investigated. This study aimed to identify in...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/15/3221 |
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| author | Romain Didier Clément Benic Bahaa Nasr Florent Le Ven Sinda Hannachi Hélène Eltchaninoff Edward Koifman Patrick Donzeau-Gouge Jean Fajadet Pascal Leprince Alain Leguerrier Michel Lièvre Alain Prat Emmanuel Teiger Thierry Lefevre Thomas Cuisset Herve Le Breton Vincent Auffret Bernard Iung Martine Gilard |
| author_facet | Romain Didier Clément Benic Bahaa Nasr Florent Le Ven Sinda Hannachi Hélène Eltchaninoff Edward Koifman Patrick Donzeau-Gouge Jean Fajadet Pascal Leprince Alain Leguerrier Michel Lièvre Alain Prat Emmanuel Teiger Thierry Lefevre Thomas Cuisset Herve Le Breton Vincent Auffret Bernard Iung Martine Gilard |
| author_sort | Romain Didier |
| collection | DOAJ |
| description | Mean Gradient (MG) elevation can be detected immediately after transcatheter aortic valve implantation (TAVI) or secondarily during follow-up. Comparisons and interactions between these two parameters and their impact on outcomes have not previously been investigated. This study aimed to identify incidence, influence on prognosis, and parameters associated with immediate high post-procedural mean transvalvular gradient (PPMG) and delayed mean gradient increase (6 to 12 months after TAVI, DMGI) in the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry. The registry includes all consecutive symptomatic patients with severe aortic stenosis who have undergone TAVI. Three groups were analyzed: (1) PPMG < 20 mmHg without DMGI > 10 mmHg (control); (2) PPMG < 20 mmHg with DMGI > 10 mmHg (Group 1); and (3) PPMG ≥ 20 mmHg (Group 2). From January 2010 to January 2012, 4201 consecutive patients were prospectively enrolled in the registry. Controls comprised 2078 patients. In Group 1(<i>n</i> = 131 patients), DMGI exceeded 10 mmHg in 5.6%, and was not associated with greater 4-years mortality than in controls (32.6% vs. 40.1%, <i>p</i> = 0.27). In Group 2 (<i>n</i> = 144 patients), PPMG was at least 20 mmHg in 6.1% and was associated with higher 4-year mortality (48.7% versus 40.1%, <i>p</i> = 0.005). A total of two-thirds of the patients with PPMG ≥ 20 mmHg had MG < 20 mmHg at 1 year, with mortality similar to the controls (39.2% vs. 40.1%, <i>p</i> = 0.73). Patients with PPMG > 20 mmHg 1 year post-TAVI had higher 4-years mortality than the general population of the registry, unlike patients with MG normalization. |
| first_indexed | 2024-03-10T09:14:03Z |
| format | Article |
| id | doaj.art-6d7d225eb4b047208aab7d2086b06444 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T09:14:03Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-6d7d225eb4b047208aab7d2086b064442023-11-22T05:47:37ZengMDPI AGJournal of Clinical Medicine2077-03832021-07-011015322110.3390/jcm10153221High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 RegistryRomain Didier0Clément Benic1Bahaa Nasr2Florent Le Ven3Sinda Hannachi4Hélène Eltchaninoff5Edward Koifman6Patrick Donzeau-Gouge7Jean Fajadet8Pascal Leprince9Alain Leguerrier10Michel Lièvre11Alain Prat12Emmanuel Teiger13Thierry Lefevre14Thomas Cuisset15Herve Le Breton16Vincent Auffret17Bernard Iung18Martine Gilard19Department of Cardiology, University Hospital of Brest, 29200 Brest, FranceDepartment of Cardiology, University Hospital of Brest, 29200 Brest, FranceDepartment of Cardiology, University Hospital of Brest, 29200 Brest, FranceDepartment of Cardiology, University Hospital of Brest, 29200 Brest, FranceDepartment of Cardiology, University Hospital of Brest, 29200 Brest, FranceCardiology Service, Rouen-Charles-Nicolle University Hospital Center, National Institute of Health and Medical Research U644, 76000 Rouen, FranceDivision of Cardiology, Soroka Medical Center, Beer-Sheva P.O. Box 151, IsraelDepartment of Cardiology and Surgery, Institut Cardiovasculaire Paris Sud, 91300 Massy, FranceClinique Pasteur, 31000 Toulouse, FranceCardiothoracic Surgery Department, La Pitié-Salpétrière Hospital, 75651 Paris, FranceCardiology and Vascular Diseases Service, Pontchaillou University Hospital Center, 35000 Rennes, FranceFaculty of Medecine Laënnec, University Claude Bernard Lyon, 69000 Lyon, FranceCardiologic Hospital, 3 bd du Pr, Leclercq, CEDEX, 59037 Lille, FranceDepartment of Cardiology, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris, 94000 Creteil, FranceDepartment of Cardiology and Surgery, Institut Cardiovasculaire Paris Sud, 91300 Massy, FranceDepartment of Cardiology, La Timone University Hospital Center, Public Assistance Hospitals of Marseille, National Institute of Health and Medical Research UMR 1062, French National Institute for Agricultural Research UMR 1260, University of Aix-Marseille, 13000 Marseille, FranceCardiology and Vascular Diseases Service, Pontchaillou University Hospital Center, 35000 Rennes, FranceCardiology and Vascular Diseases Service, Pontchaillou University Hospital Center, 35000 Rennes, FranceDepartment of Cardiology, University Hospital Department Fire and Paris-Diderot University, Public Assistance Hospitals of Paris, Bichat Hospital, 75013 Paris, FranceDepartment of Cardiology, University Hospital of Brest, 29200 Brest, FranceMean Gradient (MG) elevation can be detected immediately after transcatheter aortic valve implantation (TAVI) or secondarily during follow-up. Comparisons and interactions between these two parameters and their impact on outcomes have not previously been investigated. This study aimed to identify incidence, influence on prognosis, and parameters associated with immediate high post-procedural mean transvalvular gradient (PPMG) and delayed mean gradient increase (6 to 12 months after TAVI, DMGI) in the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry. The registry includes all consecutive symptomatic patients with severe aortic stenosis who have undergone TAVI. Three groups were analyzed: (1) PPMG < 20 mmHg without DMGI > 10 mmHg (control); (2) PPMG < 20 mmHg with DMGI > 10 mmHg (Group 1); and (3) PPMG ≥ 20 mmHg (Group 2). From January 2010 to January 2012, 4201 consecutive patients were prospectively enrolled in the registry. Controls comprised 2078 patients. In Group 1(<i>n</i> = 131 patients), DMGI exceeded 10 mmHg in 5.6%, and was not associated with greater 4-years mortality than in controls (32.6% vs. 40.1%, <i>p</i> = 0.27). In Group 2 (<i>n</i> = 144 patients), PPMG was at least 20 mmHg in 6.1% and was associated with higher 4-year mortality (48.7% versus 40.1%, <i>p</i> = 0.005). A total of two-thirds of the patients with PPMG ≥ 20 mmHg had MG < 20 mmHg at 1 year, with mortality similar to the controls (39.2% vs. 40.1%, <i>p</i> = 0.73). Patients with PPMG > 20 mmHg 1 year post-TAVI had higher 4-years mortality than the general population of the registry, unlike patients with MG normalization.https://www.mdpi.com/2077-0383/10/15/3221mean gradientstructural valve degenerationTAVIpost-procedural mean gradient |
| spellingShingle | Romain Didier Clément Benic Bahaa Nasr Florent Le Ven Sinda Hannachi Hélène Eltchaninoff Edward Koifman Patrick Donzeau-Gouge Jean Fajadet Pascal Leprince Alain Leguerrier Michel Lièvre Alain Prat Emmanuel Teiger Thierry Lefevre Thomas Cuisset Herve Le Breton Vincent Auffret Bernard Iung Martine Gilard High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry Journal of Clinical Medicine mean gradient structural valve degeneration TAVI post-procedural mean gradient |
| title | High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry |
| title_full | High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry |
| title_fullStr | High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry |
| title_full_unstemmed | High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry |
| title_short | High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry |
| title_sort | high post procedural transvalvular gradient or delayed mean gradient increase after transcatheter aortic valve implantation incidence prognosis and associated variables the france 2 registry |
| topic | mean gradient structural valve degeneration TAVI post-procedural mean gradient |
| url | https://www.mdpi.com/2077-0383/10/15/3221 |
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