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Clinical impact of paravalvular leaks on biomarkers and survival after transcatheter aortic valve implantation

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Clinical impact of paravalvular leaks on biomarkers and survival after transcatheter aortic valve implantation. / Schewel, Dimitry; Frerker, Christian; Schewel, Jury; Wohlmuth, Peter; Meincke, Felix; Thielsen, Thomas; Kreidel, Felix; Kuck, Karl-Heinz; Schäfer, Ulrich.

in: CATHETER CARDIO INTE, Jahrgang 85, Nr. 3, 15.02.2015, S. 502-514.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Schewel, D, Frerker, C, Schewel, J, Wohlmuth, P, Meincke, F, Thielsen, T, Kreidel, F, Kuck, K-H & Schäfer, U 2015, 'Clinical impact of paravalvular leaks on biomarkers and survival after transcatheter aortic valve implantation', CATHETER CARDIO INTE, Jg. 85, Nr. 3, S. 502-514. https://doi.org/10.1002/ccd.25295

APA

Schewel, D., Frerker, C., Schewel, J., Wohlmuth, P., Meincke, F., Thielsen, T., Kreidel, F., Kuck, K-H., & Schäfer, U. (2015). Clinical impact of paravalvular leaks on biomarkers and survival after transcatheter aortic valve implantation. CATHETER CARDIO INTE, 85(3), 502-514. https://doi.org/10.1002/ccd.25295

Vancouver

Schewel D, Frerker C, Schewel J, Wohlmuth P, Meincke F, Thielsen T et al. Clinical impact of paravalvular leaks on biomarkers and survival after transcatheter aortic valve implantation. CATHETER CARDIO INTE. 2015 Feb 15;85(3):502-514. https://doi.org/10.1002/ccd.25295

Bibtex

@article{df2e70bfa445480fa6918616de2ec8ad,
title = "Clinical impact of paravalvular leaks on biomarkers and survival after transcatheter aortic valve implantation",
abstract = "BACKGROUND: There is accumulating evidence that up to 20% of the implanted devices after TAVI are associated with a significant degree of paravalvular leaks, which appear to be associated with a negative clinical outcome.METHODS: A total of 355 patients with severe aortic valvular stenosis (AVS) were treated by TAVI (Corevalve n = 222, Edwards Sapien n = 133). Survival, NT-proBNP and the grade of PVL were quantified up to 12 months after implantation.RESULTS: Technical success rate was 97.8%. Thirty-day mortality was 9.6%. Post-procedural transvalvular aortic regurgitation was seen only in a minority of cases (5%), whereas PVL were frequently observed (grade: <1+ in 58.2%, ≥1-<2 in 33.9%, and ≥2 in 7.9%). There was a clear relation-ship between PVL and adverse outcome (P < 0.001). After a transient increase, NT-proBNP showed a significant decline. Interestingly, a PVL ≥2+ was associated with a much higher rise in NT-proBNP compared to the other groups (P < 0.01), and a post-procedural increase in NT-proBNP by more than 1640 ng L(-1) within 5 days was associated with a significant increase in rate of death (P < 0.01).CONCLUSIONS: TAVI is an efficient treatment option for high-risk patients with severe AVS. The incidence of PVL is an inacceptable clinical problem. Serial measurement of NT-proBNP can be used for risk-stratification in patients with a significant PVL. In general, PVL graded ≥2+ is associated with a dramatically increased 6-month mortality. Therefore, any action to reduce paraprosthetical regurgitation is highly recommended.",
keywords = "Aged, Aged, 80 and over, Aortic Valve Insufficiency/blood, Aortic Valve Stenosis/diagnosis, Biomarkers/blood, Cardiac Catheterization/adverse effects, Female, Germany, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation/adverse effects, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Natriuretic Peptide, Brain/blood, Peptide Fragments/blood, Predictive Value of Tests, Proportional Hazards Models, Prosthesis Failure, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome",
author = "Dimitry Schewel and Christian Frerker and Jury Schewel and Peter Wohlmuth and Felix Meincke and Thomas Thielsen and Felix Kreidel and Karl-Heinz Kuck and Ulrich Sch{\"a}fer",
note = "{\textcopyright} 2013 Wiley Periodicals, Inc.",
year = "2015",
month = feb,
day = "15",
doi = "10.1002/ccd.25295",
language = "English",
volume = "85",
pages = "502--514",
journal = "CATHETER CARDIO INTE",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",
number = "3",

}

RIS

TY - JOUR

T1 - Clinical impact of paravalvular leaks on biomarkers and survival after transcatheter aortic valve implantation

AU - Schewel, Dimitry

AU - Frerker, Christian

AU - Schewel, Jury

AU - Wohlmuth, Peter

AU - Meincke, Felix

AU - Thielsen, Thomas

AU - Kreidel, Felix

AU - Kuck, Karl-Heinz

AU - Schäfer, Ulrich

N1 - © 2013 Wiley Periodicals, Inc.

PY - 2015/2/15

Y1 - 2015/2/15

N2 - BACKGROUND: There is accumulating evidence that up to 20% of the implanted devices after TAVI are associated with a significant degree of paravalvular leaks, which appear to be associated with a negative clinical outcome.METHODS: A total of 355 patients with severe aortic valvular stenosis (AVS) were treated by TAVI (Corevalve n = 222, Edwards Sapien n = 133). Survival, NT-proBNP and the grade of PVL were quantified up to 12 months after implantation.RESULTS: Technical success rate was 97.8%. Thirty-day mortality was 9.6%. Post-procedural transvalvular aortic regurgitation was seen only in a minority of cases (5%), whereas PVL were frequently observed (grade: <1+ in 58.2%, ≥1-<2 in 33.9%, and ≥2 in 7.9%). There was a clear relation-ship between PVL and adverse outcome (P < 0.001). After a transient increase, NT-proBNP showed a significant decline. Interestingly, a PVL ≥2+ was associated with a much higher rise in NT-proBNP compared to the other groups (P < 0.01), and a post-procedural increase in NT-proBNP by more than 1640 ng L(-1) within 5 days was associated with a significant increase in rate of death (P < 0.01).CONCLUSIONS: TAVI is an efficient treatment option for high-risk patients with severe AVS. The incidence of PVL is an inacceptable clinical problem. Serial measurement of NT-proBNP can be used for risk-stratification in patients with a significant PVL. In general, PVL graded ≥2+ is associated with a dramatically increased 6-month mortality. Therefore, any action to reduce paraprosthetical regurgitation is highly recommended.

AB - BACKGROUND: There is accumulating evidence that up to 20% of the implanted devices after TAVI are associated with a significant degree of paravalvular leaks, which appear to be associated with a negative clinical outcome.METHODS: A total of 355 patients with severe aortic valvular stenosis (AVS) were treated by TAVI (Corevalve n = 222, Edwards Sapien n = 133). Survival, NT-proBNP and the grade of PVL were quantified up to 12 months after implantation.RESULTS: Technical success rate was 97.8%. Thirty-day mortality was 9.6%. Post-procedural transvalvular aortic regurgitation was seen only in a minority of cases (5%), whereas PVL were frequently observed (grade: <1+ in 58.2%, ≥1-<2 in 33.9%, and ≥2 in 7.9%). There was a clear relation-ship between PVL and adverse outcome (P < 0.001). After a transient increase, NT-proBNP showed a significant decline. Interestingly, a PVL ≥2+ was associated with a much higher rise in NT-proBNP compared to the other groups (P < 0.01), and a post-procedural increase in NT-proBNP by more than 1640 ng L(-1) within 5 days was associated with a significant increase in rate of death (P < 0.01).CONCLUSIONS: TAVI is an efficient treatment option for high-risk patients with severe AVS. The incidence of PVL is an inacceptable clinical problem. Serial measurement of NT-proBNP can be used for risk-stratification in patients with a significant PVL. In general, PVL graded ≥2+ is associated with a dramatically increased 6-month mortality. Therefore, any action to reduce paraprosthetical regurgitation is highly recommended.

KW - Aged

KW - Aged, 80 and over

KW - Aortic Valve Insufficiency/blood

KW - Aortic Valve Stenosis/diagnosis

KW - Biomarkers/blood

KW - Cardiac Catheterization/adverse effects

KW - Female

KW - Germany

KW - Heart Valve Prosthesis

KW - Heart Valve Prosthesis Implantation/adverse effects

KW - Humans

KW - Kaplan-Meier Estimate

KW - Male

KW - Middle Aged

KW - Natriuretic Peptide, Brain/blood

KW - Peptide Fragments/blood

KW - Predictive Value of Tests

KW - Proportional Hazards Models

KW - Prosthesis Failure

KW - Risk Assessment

KW - Risk Factors

KW - Severity of Illness Index

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1002/ccd.25295

DO - 10.1002/ccd.25295

M3 - SCORING: Journal article

C2 - 24259366

VL - 85

SP - 502

EP - 514

JO - CATHETER CARDIO INTE

JF - CATHETER CARDIO INTE

SN - 1522-1946

IS - 3

ER -