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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
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Mildly reduced and reduced ejection fraction heart failure patients have worst outcomes after transvalvular catheter aortic valve implantation
Session:
Posters (Sessão 5 - Écran 5) - Intervenção Valvular Aórtica Percutânea 2
Speaker:
Francisco Homem de Gouveia e Sousa
Congress:
CPC 2023
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Francisco Sousa; Débora Sá; Marina Santos; Margarida Temtem; Ricardo Rodrigues; Bruno Silva; Graça Caires; Marco Serrão; João Adriano Sousa; Diogo Rijo; João Manuel Rodrigues; António Drumond Freitas
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Background: Left Ventricular Ejection Fraction (LVEF) < 50% is known to be associated with worse prognosis in patients with aortic stenosis. The aim of this study is to determine if Heart Failure with Mildly Reduced Ejection Fraction (HFmrEF) and Heart Failure with Reduced Ejection Fraction (HFrEF) is a worst prognostic marker after transvalvular catheter aortic valve implantation (TAVI). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods: A total of 73 patients were submitted to TAVI. Group A - HfrEF and HFmrEF (n=20) and group B - HFpEF (n=53). Follow-up was made by regular medical appointments and through medical records. Mean follow-up in group A was 2.1±1.22 years vs B=2.4±1.0 years). Recorded Major Adverse Cardiovascular Events (MACE) were the following: unstable angina; myocardial infarction; stroke; heart failure hospitalizations; cardiovascular death. Single or multiple hospitalizations for Heart failure were counted only as 1 MACE. Both groups were compared according to the number of MACE using Mann-Witney test and Heart failure hospitalizations compared through Chi-square test.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results: There were no significant differences between both groups regarding basal characteristics (mean age: A=80.9±6.7years, B=81±4.9 years, A: 50% male, B=51% male, p=n.s.). Group A registered 9 MACE (45%) and group B 11 MACE (21%), p=0.039. One patient in each group had 2 different events. MACE proportion through groups was divided as: unstable angina (n=1) (A=5%; B=0%); myocardial infarction n=2 (A=10%; B=0%); stroke n=4 (A=0%; B=8%); hospitalizations due to Heart Failure n=15 (A=40%;B=13.2%, p<0.001). No cardiovascular deaths were reported. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion: Worst outcomes were observed in patients with HFmrEF and HFrEF. A particular impact was observed on heart failure hospitalizations. Prolonged and severe aortic stenosis may be responsible for reduced Ejection Fraction. Larger populations studies maybe helpful to determine if an earlier intervention would prevent MACE.</span></span></p>
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