Does a Gradient-Adjusted Cardiac Power Index Improve Prediction of Post-Transcatheter Aortic Valve Replacement Survival Over Cardiac Power Index?
Aortic valve stenosis
hemodynamics
mortality
transcatheter aortic valve replacement
Journal
Yonsei medical journal
ISSN: 1976-2437
Titre abrégé: Yonsei Med J
Pays: Korea (South)
ID NLM: 0414003
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
10
02
2020
revised:
03
04
2020
accepted:
11
04
2020
entrez:
30
5
2020
pubmed:
30
5
2020
medline:
28
7
2020
Statut:
ppublish
Résumé
Cardiac power (CP) index is a product of mean arterial pressure (MAP) and cardiac output (CO). In aortic stenosis, however, MAP is not reflective of true left ventricular (LV) afterload. We evaluated the utility of a gradient-adjusted CP (GCP) index in predicting survival after transcatheter aortic valve replacement (TAVR), compared to CP alone. We included 975 patients who underwent TAVR with 1 year of follow-up. CP was calculated as (CO×MAP)/[451×body surface area (BSA)] (W/m²). GCP was calculated using augmented MAP by adding aortic valve mean gradient (AVMG) to systolic blood pressure (CP1), adding aortic valve maximal instantaneous gradient to systolic blood pressure (CP2), and adding AVMG to MAP (CP3). A multivariate Cox regression analysis was performed adjusting for baseline covariates. Receiver operator curves (ROC) for CP and GCP were calculated to predict survival after TAVR. The mortality rate at 1 year was 16%. The mean age and AVMG of the survivors were 81±9 years and 43±4 mm Hg versus 80±9 years and 42±13 mm Hg in the deceased group. The proportions of female patients were similar in both groups ( GCP did not improve the accuracy of predicting survival post TAVR at 1 year, compared to CP alone.
Identifiants
pubmed: 32469172
pii: 61.482
doi: 10.3349/ymj.2020.61.6.482
pmc: PMC7256004
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
482-491Informations de copyright
© Copyright: Yonsei University College of Medicine 2020.
Déclaration de conflit d'intérêts
The authors have no potential conflicts of interest to disclose.
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