Prognostic Impact of Low-Flow Severe Aortic Stenosis in Small-Body Patients Undergoing TAVR: The OCEAN-TAVI Registry

JACC. Cardiovascular Imaging
Akihisa KataokaOCEAN-TAVI Investigators

Abstract

This study aimed to analyze the prognostic impact of low-flow (LF) severe aortic stenosis in small-body patients undergoing transcatheter aortic valve replacement (TAVR). Western literature demonstrates a poor prognosis with paradoxical LF and low-flow low-gradient (LF-LG) severe aortic stenosis (AS), as defined by stroke volume index (SVi) <35 ml/m2 and mean pressure gradient <40 mm Hg with preserved left ventricular ejection fraction (LVEF). However, this poor prognosis is contested in Japan owing to the smaller body size of Japanese patients relative to that of Western patients. Additionally, there are no reports of the prognostic implication of paradoxical LF or LF-LG severe AS in small-body patients undergoing TAVR. This was a retrospective analysis of 723 consecutive Japanese patients (median age 85 years; 32.6% male; median body surface area 1.4 m2) who underwent TAVR for severe AS at 9 sites in Japan. The primary and secondary endpoints were cumulative all-cause and cardiovascular mortality after TAVR, respectively. Ninety-seven (13.4%) patients had paradoxical LF severe AS whereas 38 (5.3%) had paradoxical LF-LG with severe AS. PLF was associated with a significant increase in all-cause (hazard ratio [HR]: 3.00; 95% co...Continue Reading

Citations

Feb 13, 2018·Current Cardiology Reports·Caroline Bleakley, Mark J Monaghan
Sep 11, 2019·Cardiovascular Intervention and Therapeutics·Kohsuke Shirakawa, Mitsushige Murata
Jul 19, 2019·Journal of Cardiovascular Medicine·Hisato TakagiUNKNOWN ALICE (All-Literature Investigation of Cardiovascular Evidence) Group
Jul 11, 2020·Current Cardiology Reports·Vidhu AnandMackram Eleid
Jan 18, 2020·Journal of the American College of Cardiology·Y Chandrashekhar
Oct 15, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Nihal WildeVedat Tiyerili
Mar 23, 2021·Journal of the American Heart Association·Tetsuya SaitoKentaro Hayashida
Nov 25, 2020·Journal of Cardiovascular Medicine·Yukihiro SaitoSatoru Osaki
Mar 30, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Toshihisa AnzaiUNKNOWN Japanese Circulation Society Joint Working Group

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