Comparison of Different Invasive Hemodynamic Measurements as a Prediction Tool for Mortality after Transcatheter Aortic Valve Replacement in Men: A Retrospective Observational Study

摘要

IntroductionHemodynamic measurements can assess for paravalvular aortic regurgitation after transcatheter aortic valve replacement (TAVR). This study compared the utility of different invasive hemodynamic measures in providing prognostic information. MethodsThis retrospective observational study of TAVR patients at a Veterans Hospital assessed aortic regurgitation index, diastolic delta, pulse pressure, and heart rate adjusted diastolic delta obtained at valve implantation. The primary outcome was total mortality. ResultsOverall, 151 patients underwent TAVR. Immediately after implantation, mean aortic regurgitation index was 31?±?8.6, mean diastolic delta was 38?±?9.8?mmHg, mean pulse pressure was 67?±?18?mmHg, and mean heart rate adjusted diastolic delta was 47?±?14.3?mmHg/beats per minute. Two percent of patients had?≥?moderate paravalvular aortic regurgitation by postoperative transthoracic echocardiography. Total mortality was 15.2% at a mean follow-up of 12.7?±?9.2?months. Aortic regurgitation index 60 vs. ≤60?mmHg were not associated with total mortality. However, total mortality was 50% for heart rate adjusted diastolic delta ConclusionsAmong a cohort of TAVR patients, the only invasive hemodynamic test independently associated with total mortality was heart rate adjusted diastolic delta.