PMID- 36653770 OWN - NLM STAT- MEDLINE DCOM- 20230120 LR - 20230202 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 23 IP - 1 DP - 2023 Jan 18 TI - Effectiveness and safety of transcatheter aortic valve replacement in elderly people with severe aortic stenosis with different types of heart failure. PG - 34 LID - 10.1186/s12872-023-03048-7 [doi] LID - 34 AB - BACKGROUND: Impaired left ventricular function is an independent predictor of adverse clinical outcomes in patients with aortic stenosis. The aim of this study is to evaluate the short-term changes of echocardiographic parameters, New York Heart Association (NYHA) class and B-type natriuretic peptide (BNP) level and adverse events amongst patients with heart failure (HF) after transcatheter aortic valve replacement (TAVR) procedure. METHODS: This was a retrospective cohort study conducted at affiliated Yantai Yuhuangding Hospital of Qingdao University between September 2017 and September 2022. TAVR cases were stratified into three groups [heart failure with reduced ejection fraction (HFrEF), heart failure with mildly reduced ejection fraction (HFmrEF), heart failure with preserved ejection fraction (HFpEF)] by left ventricular ejection fraction (LVEF). Baseline characteristics, changes in echocardiographic parameters (1 week and 1 month), BNP (1 month), and NYHA class (6 months) post-TAVR were compared across the three groups. Meanwhile, we observed the adverse events of the patients after TAVR. RESULTS: A total of 96 patients were included, of whom 15 (15.6%) had HFrEF, 15 (15.6%) had HFmrEF, and 66 (68.8%) had HFpEF. Compared to the HFpEF subgroup, patients in the HFrEF subgroup were younger (p < 0.05), and with a higher BNP (p < 0.05). The left ventricular end-diastolic dimension (LVEDD) in HFrEF group decreased significantly after TAVR. HFmrEF and HFrEF patients showed significant improvements in LVEF after TAVR. The pulmonary artery systolic pressure (PASP), aortic valve peak gradient (AVPG) and aortic valve peak gradient (V(max)) decreased significantly 1 month after TAVR in all three groups compared to the baseline (all p < 0.05). BNP significantly reduced in HFrEF group compared to HFpEF patients after TAVR (p < 0.05). The majority of patients experienced an improvement at least one NYHA class in all three groups 6 months post-TAVR. There is no significant increase in the risk of adverse events in the HFrEF group. CONCLUSIONS: Patients who underwent TAVR achieved significant improvements in BNP, NYHA class, LVEDD, LVEF, and PASP across the three HF classes, with a more rapid and pronounced improvement in the HFrEF and HFmrEF groups. Complication rates were low in the different HF groups. There is no significant increase in the risk of periprocedural complications in the HFrEF and HFmrEF groups. CI - (c) 2023. The Author(s). FAU - Dong, Mei AU - Dong M AD - Department of Cardiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China. FAU - Wang, Lizhen AU - Wang L AD - Department of Cardiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China. FAU - Tse, Gary AU - Tse G AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. AD - Kent and Medway Medical School, Canterbury, CT2 7FS, UK. AD - School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China. FAU - Dai, Tao AU - Dai T AD - Department of Cardiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China. FAU - Wang, Lihong AU - Wang L AD - Department of Ultrasound, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China. FAU - Xiao, Zhicheng AU - Xiao Z AD - Department of Cardiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China. FAU - Liu, Tong AU - Liu T AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. liutong@tmu.edu.cn. FAU - Ren, Faxin AU - Ren F AD - Department of Cardiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China. drren@163.com. LA - eng PT - Journal Article DEP - 20230118 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Humans MH - Aged MH - Ventricular Function, Left MH - Stroke Volume MH - *Heart Failure/diagnostic imaging/etiology/therapy MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Prognosis MH - Retrospective Studies MH - *Aortic Valve Stenosis/complications/diagnostic imaging/surgery MH - Aortic Valve/diagnostic imaging/surgery PMC - PMC9850637 OTO - NOTNLM OT - Heart failure with mildly reduced ejection fraction OT - Heart failure with preserved ejection fraction OT - Heart failure with reduced ejection fraction OT - Severe aortic stenosis OT - Transcatheter aortic valve replacement COIS- The authors declare that they have no competing interests. EDAT- 2023/01/19 06:00 MHDA- 2023/01/21 06:00 PMCR- 2023/01/18 CRDT- 2023/01/18 23:34 PHST- 2022/09/05 00:00 [received] PHST- 2023/01/06 00:00 [accepted] PHST- 2023/01/18 23:34 [entrez] PHST- 2023/01/19 06:00 [pubmed] PHST- 2023/01/21 06:00 [medline] PHST- 2023/01/18 00:00 [pmc-release] AID - 10.1186/s12872-023-03048-7 [pii] AID - 3048 [pii] AID - 10.1186/s12872-023-03048-7 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2023 Jan 18;23(1):34. doi: 10.1186/s12872-023-03048-7.