Impact of Left Ventricular Diastolic Pressure Changes on Clinical Outcomes After Transcatheter Aortic Valve Replacement
Changes in left ventricular (LV) diastolic pressure after transcatheter aortic valve replacement (TAVR) or their relationship with subsequent outcomes remain poorly clarified. Accordingly, we aimed to assess the changes in invasively measured LV diastolic pressure and their relationship with long‐te...
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Wiley
2025-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.039372 |
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| author | Jiwon Seo Ah‐Ram Kim Iksung Cho Chi Young Shim Geu‐Ru Hong Eui‐Young Choi Se‐Joong Rim Young‐Guk Ko Myeong‐Ki Hong Jae‐Kwan Song Jong‐Won Ha |
| author_facet | Jiwon Seo Ah‐Ram Kim Iksung Cho Chi Young Shim Geu‐Ru Hong Eui‐Young Choi Se‐Joong Rim Young‐Guk Ko Myeong‐Ki Hong Jae‐Kwan Song Jong‐Won Ha |
| author_sort | Jiwon Seo |
| collection | DOAJ |
| description | Changes in left ventricular (LV) diastolic pressure after transcatheter aortic valve replacement (TAVR) or their relationship with subsequent outcomes remain poorly clarified. Accordingly, we aimed to assess the changes in invasively measured LV diastolic pressure and their relationship with long‐term outcomes in patients undergoing TAVR. Methods In total, 509 patients with severe aortic stenosis who underwent TAVR at 3 tertiary centers were retrospectively included and divided into 2 groups according to changes in LV pre‐A pressure after TAVR: Group 1, with no change or decrease in pre‐A pressure, and Group 2, presenting an increase in pre‐A pressure after TAVR. The primary outcome was a composite of all‐cause death and rehospitalization for heart failure. Results Group 1 included 39% (n=198) patients, and Group 2 had 61% (n=311) patients. More patients in Group 2 had diabetes, chronic kidney disease, and a larger aortic valve area than in Group 1. During the follow‐up period (median, 28 months), 122 primary outcomes were recorded. In Kaplan‐Meier analysis, the cumulative incidence of the primary outcome and all‐cause death was significantly lower in Group 1 than in Group 2. In multivariable Cox hazard models, Group 1 was independently associated with a favorable primary outcome (hazard ratio, 0.52 [95% CI, 0.34–0.80]; P=0.003). Conclusions Increase in LV pre‐A pressure after TAVR is common, and no change or decrease in LV pre‐A pressure after TAVR is independently associated with favorable outcomes. Changes in LV pre‐A pressure can help identify patient subsets who will maximally benefit from TAVR. |
| format | Article |
| id | doaj-art-4dad02f887e34ce5b1ed2f315a01bf9e |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-4dad02f887e34ce5b1ed2f315a01bf9e2025-08-20T02:37:25ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-06-01141110.1161/JAHA.124.039372Impact of Left Ventricular Diastolic Pressure Changes on Clinical Outcomes After Transcatheter Aortic Valve ReplacementJiwon Seo0Ah‐Ram Kim1Iksung Cho2Chi Young Shim3Geu‐Ru Hong4Eui‐Young Choi5Se‐Joong Rim6Young‐Guk Ko7Myeong‐Ki Hong8Jae‐Kwan Song9Jong‐Won Ha10Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology, Heart Institute, Asan Medical Center University of Ulsan College of Medicine Seoul Republic of KoreaDivision of Cardiology, Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology, Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology, Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology, Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology, Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Cardiology, Heart Institute, Asan Medical Center University of Ulsan College of Medicine Seoul Republic of KoreaDivision of Cardiology, Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul Republic of KoreaChanges in left ventricular (LV) diastolic pressure after transcatheter aortic valve replacement (TAVR) or their relationship with subsequent outcomes remain poorly clarified. Accordingly, we aimed to assess the changes in invasively measured LV diastolic pressure and their relationship with long‐term outcomes in patients undergoing TAVR. Methods In total, 509 patients with severe aortic stenosis who underwent TAVR at 3 tertiary centers were retrospectively included and divided into 2 groups according to changes in LV pre‐A pressure after TAVR: Group 1, with no change or decrease in pre‐A pressure, and Group 2, presenting an increase in pre‐A pressure after TAVR. The primary outcome was a composite of all‐cause death and rehospitalization for heart failure. Results Group 1 included 39% (n=198) patients, and Group 2 had 61% (n=311) patients. More patients in Group 2 had diabetes, chronic kidney disease, and a larger aortic valve area than in Group 1. During the follow‐up period (median, 28 months), 122 primary outcomes were recorded. In Kaplan‐Meier analysis, the cumulative incidence of the primary outcome and all‐cause death was significantly lower in Group 1 than in Group 2. In multivariable Cox hazard models, Group 1 was independently associated with a favorable primary outcome (hazard ratio, 0.52 [95% CI, 0.34–0.80]; P=0.003). Conclusions Increase in LV pre‐A pressure after TAVR is common, and no change or decrease in LV pre‐A pressure after TAVR is independently associated with favorable outcomes. Changes in LV pre‐A pressure can help identify patient subsets who will maximally benefit from TAVR.https://www.ahajournals.org/doi/10.1161/JAHA.124.039372aortic stenosisdiastolic functiontranscatheter aortic valve replacement |
| spellingShingle | Jiwon Seo Ah‐Ram Kim Iksung Cho Chi Young Shim Geu‐Ru Hong Eui‐Young Choi Se‐Joong Rim Young‐Guk Ko Myeong‐Ki Hong Jae‐Kwan Song Jong‐Won Ha Impact of Left Ventricular Diastolic Pressure Changes on Clinical Outcomes After Transcatheter Aortic Valve Replacement Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aortic stenosis diastolic function transcatheter aortic valve replacement |
| title | Impact of Left Ventricular Diastolic Pressure Changes on Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_full | Impact of Left Ventricular Diastolic Pressure Changes on Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_fullStr | Impact of Left Ventricular Diastolic Pressure Changes on Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_full_unstemmed | Impact of Left Ventricular Diastolic Pressure Changes on Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_short | Impact of Left Ventricular Diastolic Pressure Changes on Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_sort | impact of left ventricular diastolic pressure changes on clinical outcomes after transcatheter aortic valve replacement |
| topic | aortic stenosis diastolic function transcatheter aortic valve replacement |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.039372 |
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