Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
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
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
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
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Contractile Reserve and Survival Outcomes in Transcatheter Aortic Valve Implantation for Low-Flow, Low-Gradient Aortic Stenosis
Session:
Sessão de Posters 08 - Intervenção estrutural: TAVI
Speaker:
Tatiana Pereira dos Santos
Congress:
CPC 2024
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
Tatiana Pereira Dos Santos; Ana L. Silva; Gonçalo Terleira Batista; Mariana Rodrigues Simões; Rafaela Fernandes; Vanessa Lopes; Joana Guimarães; Diogo Fernandes; Elisabete Jorge; Rogério Teixeira; Marco Costa; Lino Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Background: Few data exist on patients with low-flow, low-gradient aortic stenosis (LFLG-AS) undergoing transcatheter aortic valve replacement (TAVR). Also, very scarce data exist on the usefulness of dobutamine stress echocardiography (DSE) before TAVR in these patients.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Purpose: This study seeks to assess the prognostic significance of contractile reserve at baseline in patients undergoing TAVR for low-flow, low-gradient aortic stenosis.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods: Retrospective analysis of TAVR patients (March 2020 to November 2023) at a Portuguese tertiary center. We identified cases of LFLG AS defined by left ventricular ejection fraction (LVEF) <50%, aortic valve area <1 cm² (and/or <0.6 cm²/m², severe AS) and mean gradient <40 mmHg. We included patients with a dobutamine stress echocardiogram (DSE) and evaluated contractile reserve (CR) determined by an increase in LVEF ≥5% or stroke volume ≥20% following dobutamine. Statistical analysis used Kaplan-Meier curve and t-tests.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results: Among the total cohort of 147 patients with LFLG AS, 28 patients had pre-TAVR DSE. The mean age was 76.9±8.3 years and 67.9% are male. The mean follow-up period (FUP) was 15.7±10.1 months. Cardiovascular risk factors included hypertension (85.7%), diabetes (42.9%), coronary artery disease (CAD) (33.2%)and tobacco use (21.4%). Procedurally, 88.9% used transfemoral access, and 85.7% utilized the MANTA® closing device. Contractile reserve was identified in 16 patients, while 12 did not exhibit CR. No significant differences in baseline demographics, medical history, CAD, access site, valve types or complications between the two groups. Mean LVEF for CR was 31.4% ± 8.8 and 32.08%±7.3 for absent CR (p=0.84). Mean transvalvular gradient was 26.8±7.4 mmHg and 25.2±6.1 mmHg, respectively (p=0.57). Overall mortality in LFLG TAVR was 10.9%. Kaplan-Meier analysis revealed comparable all-cause mortality between the CR and non-CR groups. Survival rates at 12 months were 85.7% with CR and 91.7% without CR, with no statistically significant difference (p=0.86). After TAVR, LVEF increased 9.4% ±10.0 (p<0.001) and no difference was found between the groups (p=0.95).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion: In summary, the presence or absence of contractile reserve in dobutamine stress echocardiography does not appear to predict differences in survival and does not influence the prognosis of patients undergoing TAVR for LFLG AS. LVEF demonstrates an increase during FUP; however, CR exhibits no discernible impact.</span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site