Abstract 14145: Stroke Volume Index Predicts Mortality of Patients Undergoing Transcatheter Aortic Valve Implantation With Concomitant Mitral Regurgitation
Introduction: Patients with severe aortic stenosis frequently suffer from concomitant mitral regurgitation (MR), which implicates cardiac hemodynamic and clinical status.
Hypothesis: We assessed the hypothesis that moderate/severe MR increases mortality of patients undergoing trancatheter aortic valve implantation (TAVI) and evaluated the possible predicting ability of pre-implantation echocardiographic assessment.
Methods: We prospectively enrolled 119 patients, retrieved clinical and echocardiographic data before and 6 months after TAVI and divided patients in two groups: none/mild and moderate/severe MR. Clinical follow-up performed in a two-year period. A low mean gradient was assumed when <40 mmHg, a low stroke volume index (SVi) when <35ml/m2 and a low ejection fraction when <45%. Statistical analysis of all-cause mortality performed with the Kaplan-Meier method and further evaluated with Cox proportional hazards analysis.
Results: Seventy six patients (64%) had none/mild and 43 (36%) had moderate/severe MR. The baseline characteristics where evenly distributed among groups except for gender, coronary artery disease, chronic obstructive pulmonary disease and pulmonary arterial systolic pressure. The median follow-up time was 23 months (mean 22±13 months). During follow-up period the cumulative probability for mortality was significantly different between groups (none/mild MR: 14.5%, moderate/severe MR: 34.9%, p=0.006). In multivariate analysis, low SVi predicted mortality adjusted for moderate/severe MR and the variables that differed at baseline [HR: 5.1, 95% CI (2.21, 11.92), p=0.001], while other echocardiographic variables did not contribute to the final model although significant in univariate analysis.
Conclusions: Patients undergoing TAVI with concomitant moderate or severe MR had increased risk for mortality in a two-year period. Pre-implantation low stroke volume index independently predicted mortality.
Author Disclosures: N. Anousakis-Vlachochristou: None. K. Toutouzas: None. M. Drakopoulou: None. K. Stathogiannis: None. G. Latsios: None. A. Synetos: None. E. Tsiamis: None. D. Tousoulis: None.
- © 2015 by American Heart Association, Inc.