PMID- 21473972
OWN - NLM
STAT- MEDLINE
DCOM- 20110614
LR  - 20121115
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 161
IP  - 4
DP  - 2011 Apr
TI  - Performance-based functional assessment of patients undergoing transcatheter 
      aortic valve implantation.
PG  - 726-34
LID - 10.1016/j.ahj.2010.12.024 [doi]
AB  - BACKGROUND: Very few data exist on the functional evaluation of patients with 
      severe symptomatic aortic stenosis undergoing transcatheter aortic valve 
      implantation (TAVI). The aims of this prospective study were (1) to evaluate the 
      Duke Activity Status Index (DASI) as a measure of functional status pre-TAVI and 
      post-TAVI, (2) to determine the clinical parameters associated with DASI changes 
      after TAVI, and (3) to compare functional status as evaluated by DASI and the New 
      York Heart Association (NYHA) class with exercise capacity as evaluated by the 
      6-minute walk test (6MWT) in such patients. METHODS: A total of 76 patients (80 +/- 
      8 years old) who underwent successful TAVI were included. All patients completed 
      the DASI self-questionnaire at baseline and at 6 months after TAVI, and 46 
      patients also performed a 6MWT. RESULTS: The mean DASI increased from 10.3 +/- 5.4 
      to 16.3 +/- 8.3 at 6 months after TAVI (P < .0001). However, the DASI did not 
      change or even decreased to some extent in 30% of patients after TAVI. Renal 
      dysfunction as evaluated by the estimated glomerular filtration rate was 
      identified as the independent predictor of DASI impairment after TAVI (OR 1.7 for 
      each decrease in estimated glomerular filtration rate of 10 mL/min/1.73 m(2), 95% 
      CI 1.3-2.3, P = .005). The mean distance walked increased from 165.9 +/- 77.6 to 
      211.8 +/- 78.7 m (P = .0001) at follow-up. The DASI showed a good correlation with 
      the distance walked at baseline (r = 0.55, P < .0001) and at follow-up (r = 0.66, 
      P < .0001). The NYHA class improved to some degree in all but 5 patients; 
      however, the NYHA class did not correlate with the results of DASI and the 6MWT. 
      CONCLUSIONS: Transcatheter aortic valve implantation was associated with a 
      significant increase in functional status at 6-month follow-up as evaluated by 
      the DASI, although no improvement was observed in about one third of patients. 
      The presence of baseline renal dysfunction better determined this lack of 
      improvement in functional status. The DASI, but not the NYHA class, correlated 
      with distance walked in the 6MWT. These results suggest that the DASI might 
      become a useful tool for evaluating both candidates for and the impact of TAVI 
      procedures.
CI  - Copyright (c) 2011 Mosby, Inc. All rights reserved.
FAU - Bagur, Rodrigo
AU  - Bagur R
AD  - Department of Cardiology, Quebec Heart and Lung Institute-Laval University, 
      Quebec City, Canada.
FAU - Rodes-Cabau, Josep
AU  - Rodes-Cabau J
FAU - Dumont, Eric
AU  - Dumont E
FAU - De Larochelliere, Robert
AU  - De Larochelliere R
FAU - Doyle, Daniel
AU  - Doyle D
FAU - Pibarot, Philippe
AU  - Pibarot P
FAU - Cote, Melanie
AU  - Cote M
FAU - Clavel, Marie-Annick
AU  - Clavel MA
FAU - Villeneuve, Jacques
AU  - Villeneuve J
FAU - Gutierrez, Marcos
AU  - Gutierrez M
FAU - Poirier, Paul
AU  - Poirier P
FAU - Bertrand, Olivier F
AU  - Bertrand OF
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/*physiopathology/*surgery
MH  - Aortic Valve Stenosis/*physiopathology/*surgery
MH  - *Cardiac Catheterization
MH  - Female
MH  - Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2011/04/09 06:00
MHDA- 2011/06/15 06:00
CRDT- 2011/04/09 06:00
PHST- 2010/08/27 00:00 [received]
PHST- 2010/12/10 00:00 [accepted]
PHST- 2011/04/09 06:00 [entrez]
PHST- 2011/04/09 06:00 [pubmed]
PHST- 2011/06/15 06:00 [medline]
AID - S0002-8703(11)00015-9 [pii]
AID - 10.1016/j.ahj.2010.12.024 [doi]
PST - ppublish
SO  - Am Heart J. 2011 Apr;161(4):726-34. doi: 10.1016/j.ahj.2010.12.024.