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Influence of aortic regurgitation after TAVI on left ventricular filling pattern.
MedLine Citation:
PMID:  25402558     Owner:  NLM     Status:  Publisher    
BACKGROUND: Paravalvular aortic regurgitation after transcatheter aortic valve implantation is associated with a hemodynamic deterioration and a poor outcome. We aim to determine the early hemodynamic effect of paravalvular aortic regurgitation in relation with the change in the left ventricle filling pattern and to assess their clinical outcome.
MATERIAL AND METHODS: 82 consecutive patients referred for transcatheter aortic valve implantation were included. Patients were classified according to the change in the left ventricular filling pattern and significant paravalvular aortic regurgitation (grade ≥2) was reported. Follow-up and incidence of death and hospitalization for heart failure were reported.
RESULTS: 16 patients (19.5%) presented a worsening of left ventricular filling pattern. The incidence of significant paravalvular aortic regurgitation was higher in the group with a worsening of left ventricular filling pattern (56.3% vs. 19.7%;p=0.009). In the multivariate analysis, the only variable significantly associated with the worsening of left ventricular filling pattern was the significant paravalvular aortic regurgitation (OR 4.84; 95%CI 1.23-19.1;p=0.024). During the follow-up (642.5 days) there was a higher incidence of the end-point of death or hospitalization for heart failure in the group with a worsening of left ventricular filling pattern (62.5 vs. 31.8%;p=0.042) and a lower event-free survival rate (long rank test=0.013).
CONCLUSIONS: The presence of a significant paravalvular aortic regurgitation is associated with a worsening in parameters of diastolic function. This finding should alert the cardiologist as patients with a worsening of left ventricular filling pattern present a higher incidence of paravalvular aortic regurgitation and a less favorable outcome. This article is protected by copyright. All rights reserved.
Luis Caballero; Daniel Saura; Juan García-Lara; Maria José Oliva; Eduardo Pinar; Josefa González-Carrillo; Miguel García-Navarro; Maria Dolores Espinosa; Mariano Valdés; Gonzalo de la Morena
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-17
Journal Detail:
Title:  European journal of clinical investigation     Volume:  -     ISSN:  1365-2362     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-17     Completed Date:  -     Revised Date:  2014-11-18    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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