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Risk prediction in patients with low-flow, low-gradient aortic stenosis and reduced ejection fraction undergoing TAVI

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Risk prediction in patients with low-flow, low-gradient aortic stenosis and reduced ejection fraction undergoing TAVI. / Ludwig, Sebastian; Goßling, Alina; Seiffert, Moritz; Westermann, Dirk; Sinning, Jan-Malte; Sugiura, Atsushi; Adam, Matti; Mauri, Victor; Frank, Derk; Seoudy, Hatim; Rudolph, Tanja; Potratz, Max; Conradi, Lenard; Schofer, Niklas.

In: OPEN HEART, Vol. 9, No. 1, e001912, 01.2022.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Ludwig, S, Goßling, A, Seiffert, M, Westermann, D, Sinning, J-M, Sugiura, A, Adam, M, Mauri, V, Frank, D, Seoudy, H, Rudolph, T, Potratz, M, Conradi, L & Schofer, N 2022, 'Risk prediction in patients with low-flow, low-gradient aortic stenosis and reduced ejection fraction undergoing TAVI', OPEN HEART, vol. 9, no. 1, e001912. https://doi.org/10.1136/openhrt-2021-001912

APA

Ludwig, S., Goßling, A., Seiffert, M., Westermann, D., Sinning, J-M., Sugiura, A., Adam, M., Mauri, V., Frank, D., Seoudy, H., Rudolph, T., Potratz, M., Conradi, L., & Schofer, N. (2022). Risk prediction in patients with low-flow, low-gradient aortic stenosis and reduced ejection fraction undergoing TAVI. OPEN HEART, 9(1), [e001912]. https://doi.org/10.1136/openhrt-2021-001912

Vancouver

Ludwig S, Goßling A, Seiffert M, Westermann D, Sinning J-M, Sugiura A et al. Risk prediction in patients with low-flow, low-gradient aortic stenosis and reduced ejection fraction undergoing TAVI. OPEN HEART. 2022 Jan;9(1). e001912. https://doi.org/10.1136/openhrt-2021-001912

Bibtex

@article{9f872db3b37b4f099d558fd0043ad5c7,
title = "Risk prediction in patients with low-flow, low-gradient aortic stenosis and reduced ejection fraction undergoing TAVI",
abstract = "OBJECTIVE: Patients with low-flow, low-gradient aortic stenosis (LFLG AS) and reduced left ventricular ejection fraction (LVEF) are known to suffer from poor prognosis after transcatheter aortic valve implantation (TAVI). This study aimed to develop a simple score system for risk prediction in this vulnerable subset of patients.METHODS: All patients with LFLG AS with reduced EF and sufficient CT data for aortic valve calcification (AVC) quantification, who underwent TAVI at five German centres, were retrospectively included. The Risk prEdiction in patients with Low Ejection Fraction low gradient aortic stenosis undergoing TAVI (RELiEF TAVI) score was developed based on multivariable Cox regression for all-cause mortality.RESULTS: Among all included patients (n=718), RELiEF TAVI score variables were defined as independent predictors of mortality: male sex (HR 1.34 (1.06, 1.68), p=0.013), underweight (HR 3.10 (1.50, 6.40), p=0.0022), chronic obstructive pulmonary disease (HR 1.55 (1.21, 1.99), p=0.001), pulmonary hypertension (HR 1.51 (1.17, 1.94), p=0.0015), atrial fibrillation (HR 1.28 (1.03, 1.60), p=0.028), stroke volume index (HR 0.96 (0.95, 0.98), p<0.001), non-transfemoral access (HR 1.36 (1.05, 1.76), p=0.021) and low AVC density (HR 1.44 (1.15, 1.79), p=0.0012). A score system was developed ranging from 0 to 12 points (risk of 1-year mortality: 13%-99%). Kaplan-Meier analysis for low (0-1 points), moderate (2-4 points) and high RELiEF TAVI score (>4 points) demonstrated rates of 18.0%, 29.0% and 46.1% (p<0.001) for all-cause mortality and 23.8%, 35.9% and 53.4% (p<0.001) for the combined endpoint of all-cause mortality or heart failure rehospitalisation after 1 year, respectively.CONCLUSIONS: The RELiEF TAVI score is based on simple clinical, echocardiographic and CT parameters and might serve as a helpful tool for risk prediction in patients with LFLG AS and reduced LVEF scheduled for TAVI.",
author = "Sebastian Ludwig and Alina Go{\ss}ling and Moritz Seiffert and Dirk Westermann and Jan-Malte Sinning and Atsushi Sugiura and Matti Adam and Victor Mauri and Derk Frank and Hatim Seoudy and Tanja Rudolph and Max Potratz and Lenard Conradi and Niklas Schofer",
note = "{\textcopyright} Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2022",
month = jan,
doi = "10.1136/openhrt-2021-001912",
language = "English",
volume = "9",
journal = "OPEN HEART",
issn = "2053-3624",
publisher = "BMJ PUBLISHING GROUP",
number = "1",

}

RIS

TY - JOUR

T1 - Risk prediction in patients with low-flow, low-gradient aortic stenosis and reduced ejection fraction undergoing TAVI

AU - Ludwig, Sebastian

AU - Goßling, Alina

AU - Seiffert, Moritz

AU - Westermann, Dirk

AU - Sinning, Jan-Malte

AU - Sugiura, Atsushi

AU - Adam, Matti

AU - Mauri, Victor

AU - Frank, Derk

AU - Seoudy, Hatim

AU - Rudolph, Tanja

AU - Potratz, Max

AU - Conradi, Lenard

AU - Schofer, Niklas

N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2022/1

Y1 - 2022/1

N2 - OBJECTIVE: Patients with low-flow, low-gradient aortic stenosis (LFLG AS) and reduced left ventricular ejection fraction (LVEF) are known to suffer from poor prognosis after transcatheter aortic valve implantation (TAVI). This study aimed to develop a simple score system for risk prediction in this vulnerable subset of patients.METHODS: All patients with LFLG AS with reduced EF and sufficient CT data for aortic valve calcification (AVC) quantification, who underwent TAVI at five German centres, were retrospectively included. The Risk prEdiction in patients with Low Ejection Fraction low gradient aortic stenosis undergoing TAVI (RELiEF TAVI) score was developed based on multivariable Cox regression for all-cause mortality.RESULTS: Among all included patients (n=718), RELiEF TAVI score variables were defined as independent predictors of mortality: male sex (HR 1.34 (1.06, 1.68), p=0.013), underweight (HR 3.10 (1.50, 6.40), p=0.0022), chronic obstructive pulmonary disease (HR 1.55 (1.21, 1.99), p=0.001), pulmonary hypertension (HR 1.51 (1.17, 1.94), p=0.0015), atrial fibrillation (HR 1.28 (1.03, 1.60), p=0.028), stroke volume index (HR 0.96 (0.95, 0.98), p<0.001), non-transfemoral access (HR 1.36 (1.05, 1.76), p=0.021) and low AVC density (HR 1.44 (1.15, 1.79), p=0.0012). A score system was developed ranging from 0 to 12 points (risk of 1-year mortality: 13%-99%). Kaplan-Meier analysis for low (0-1 points), moderate (2-4 points) and high RELiEF TAVI score (>4 points) demonstrated rates of 18.0%, 29.0% and 46.1% (p<0.001) for all-cause mortality and 23.8%, 35.9% and 53.4% (p<0.001) for the combined endpoint of all-cause mortality or heart failure rehospitalisation after 1 year, respectively.CONCLUSIONS: The RELiEF TAVI score is based on simple clinical, echocardiographic and CT parameters and might serve as a helpful tool for risk prediction in patients with LFLG AS and reduced LVEF scheduled for TAVI.

AB - OBJECTIVE: Patients with low-flow, low-gradient aortic stenosis (LFLG AS) and reduced left ventricular ejection fraction (LVEF) are known to suffer from poor prognosis after transcatheter aortic valve implantation (TAVI). This study aimed to develop a simple score system for risk prediction in this vulnerable subset of patients.METHODS: All patients with LFLG AS with reduced EF and sufficient CT data for aortic valve calcification (AVC) quantification, who underwent TAVI at five German centres, were retrospectively included. The Risk prEdiction in patients with Low Ejection Fraction low gradient aortic stenosis undergoing TAVI (RELiEF TAVI) score was developed based on multivariable Cox regression for all-cause mortality.RESULTS: Among all included patients (n=718), RELiEF TAVI score variables were defined as independent predictors of mortality: male sex (HR 1.34 (1.06, 1.68), p=0.013), underweight (HR 3.10 (1.50, 6.40), p=0.0022), chronic obstructive pulmonary disease (HR 1.55 (1.21, 1.99), p=0.001), pulmonary hypertension (HR 1.51 (1.17, 1.94), p=0.0015), atrial fibrillation (HR 1.28 (1.03, 1.60), p=0.028), stroke volume index (HR 0.96 (0.95, 0.98), p<0.001), non-transfemoral access (HR 1.36 (1.05, 1.76), p=0.021) and low AVC density (HR 1.44 (1.15, 1.79), p=0.0012). A score system was developed ranging from 0 to 12 points (risk of 1-year mortality: 13%-99%). Kaplan-Meier analysis for low (0-1 points), moderate (2-4 points) and high RELiEF TAVI score (>4 points) demonstrated rates of 18.0%, 29.0% and 46.1% (p<0.001) for all-cause mortality and 23.8%, 35.9% and 53.4% (p<0.001) for the combined endpoint of all-cause mortality or heart failure rehospitalisation after 1 year, respectively.CONCLUSIONS: The RELiEF TAVI score is based on simple clinical, echocardiographic and CT parameters and might serve as a helpful tool for risk prediction in patients with LFLG AS and reduced LVEF scheduled for TAVI.

U2 - 10.1136/openhrt-2021-001912

DO - 10.1136/openhrt-2021-001912

M3 - SCORING: Journal article

C2 - 34987075

VL - 9

JO - OPEN HEART

JF - OPEN HEART

SN - 2053-3624

IS - 1

M1 - e001912

ER -