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A novel echocardiographic hemodynamic index for predicting outcome of aortic stenosis patients following transcatheter aortic valve replacement

Author

Listed:
  • Altayyeb Yousef
  • Benjamin Hibbert
  • Joshua Feder
  • Jordan Bernick
  • Juan Russo
  • Zachary MacDonald
  • Christopher Glover
  • Alexander Dick
  • Munir Boodhwani
  • Buu-Khanh Lam
  • Marc Ruel
  • Marino Labinaz
  • Ian G Burwash

Abstract

Objective: Transcatheter aortic valve replacement (TAVR) reduces left ventricular (LV) afterload and improves prognosis in aortic stenosis (AS) patients. However, LV afterload consists of both valvular and arterial loads, and the benefits of TAVR may be attenuated if the arterial load dominates. We proposed a new hemodynamic index, the Relative Valve Load (RVL), a ratio of mean gradient (MG) and valvuloarterial impedance (Zva), to describe the relative contribution of the valvular load to the global LV load, and examined whether RVL predicted patient outcome following TAVR. Methods: A total of 258 patients with symptomatic severe AS (indexed aortic valve area (AVA) 0.75cm2, %SWL≤25% and Zva>5mmHg/ml/m2 despite equivalent or better sensitivity. In multivariable Cox analysis, RVL≤7.95ml/m2 was an independent predictor of all cause mortality (HR 3.2, CI 1.8–5.9; p

Suggested Citation

  • Altayyeb Yousef & Benjamin Hibbert & Joshua Feder & Jordan Bernick & Juan Russo & Zachary MacDonald & Christopher Glover & Alexander Dick & Munir Boodhwani & Buu-Khanh Lam & Marc Ruel & Marino Labinaz, 2018. "A novel echocardiographic hemodynamic index for predicting outcome of aortic stenosis patients following transcatheter aortic valve replacement," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-15, April.
    • Handle: RePEc:plo:pone00:0195641
    DOI: 10.1371/journal.pone.0195641
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