Background
Methods
Patient selection and follow-up
TAVI group
SAVR group
Echocardiographic studies
Statistical analysis
Results
SAVR (n = 45) | TAVI (n = 42) | p-value | |
---|---|---|---|
Age (years) [Me (P25-P75)] | 73 (68 - 78) | 83.5 (79 - 87) | <0.001 |
Female gender [n(%)] | 28 (62.2) | 26 (61.9) | 0.976 |
BSA ( m
2
) [Me (P25-P75)] | 1.76 (1.57 - 1.86) | 1.75 (1.6 - 1.8) | 0.639 |
Hypertension [n(%)] | 28 (62.2) | 35 (83.3) | 0.028 |
Diabetes mellitus [n(%)] | 13 (28.9) | 11 (26.2) | 0.778 |
Dislipidemia [n(%)] | 28 (62.2) | 26 (61.9) | 0.976 |
COPD [n(%)] | 12 (26.7) | 19 (45.2) | 0.071 |
PAD [n(%)] | 3 (6.7) | 12 (28.6) | 0.007 |
Atrial Fibrilation [n(%)] | 0 (0) | 7 (16.7) | 0.004 |
Logistic Euroscore
| 6.18 ± 2.71 | 17.86 ± 9.55 | <0.001 |
NYHA class III - IV [n(%)] | 12 (26.7) | 37 (88.1) | <0.001 |
SAVR (n = 45) | TAVI (n = 42) | SAVR vs TAVIp-value | |||
---|---|---|---|---|---|
mean ± SD | Me (P25-P75) | mean ± SD | Me (P25-P75) | ||
AV annulus (cm) | |||||
Baseline | 21.34 ± 2.18 | 21 (20 - 22.75) | 20.73 ± 2.39 | 21 (19 - 22) | 0.337b
|
AV peak velocity (cm/sec) | |||||
Baseline | 4.81 ± 0.60 | 4.76 (4.36 - 5.13) | 4.76 ± 0.61 | 4.81 (4.36 - 5.16) | 0.909b
|
6 months | 2.69 ± 0.74 | 2.51 (2.21 - 3.00) | 2.07 ± 0.51 | 2.11 (1.72 - 2.31) | <0.001a
|
p-value* | <0.001 | <0.001 | |||
AV mean gradient (mmHg) | |||||
Baseline | 57.89 ± 13.91 | 54.9 (47.13 - 66.45) | 54.67 ± 15.77 | 52.5 (44.0 - 60.3) | 0.317a
|
6 months | 17.21 ± 12.05 | 13.9 (11 - 21) | 8.86 ± 4.72 | 8.1 (5.7 - 11.4) | <0.001a
|
p-value** | <0.001 | <0.001 | |||
AVA (EOA, cm2) | |||||
Baseline | 0.69 ± 0.2 | 0.7 (0.52 - 0.83) | 0.62 ± 0.15 | 0.6 (0.51 - 0.7) | 0.070a
|
6 months | 1.5 ± 0.42 | 1.4 (1.2 - 1.75) | 1.95 ± 0.54 | 1.8 (1.5 - 2.2) | <0.001a
|
p-value** | <0.001 | <0.001 | |||
AVA index (EAOI cm2/m2) | |||||
Baseline | 0.40 ± 0.11 | 0.38 (0.32 - 0.47) | 0.37 ± 0.1 | 0.37 (0.31 - 0.42) | 0.229b
|
6 months | 0.87 ± 0.24 | 0.82 (0.68 - 1.00) | 1.16 ± 0.39 | 1.05 (0.88 - 1.36) | <0.001a
|
p-value* | <0.001 | <0.001 | |||
Δ EAOI (cm2/m2) | 0.47 ± 0.28 | 0.46 (0.3 - 0.59) | 0.79 ± 0.37 | 0.65 (0.55 - 1.03) | <0.001a
|
PPM [n (%)] | 24 (58.6) | 9 (23.1) | <0.001 | ||
Severe PPM [n (%)] | 7 (17.1) | 0 | 0.012 | ||
Paravalvular AR 6m [n (%)] | 3 (6.7) | 23 (59) | <0.001 | ||
E/
A ratio
| |||||
Baseline | 0.79 ± 0.34 | 0.72 (0.61 - 0.89) | 1.38 ± 0.87 | 1.07 (0.74 - 1.74) | <0.001b
|
6 months | 0.85 ± 0.25 | 0.81 (0.69 - 0.93) | 1.34 ± 1.22 | 0.73 (0.57 - 1.74) | 0.703b
|
p-value* | 0.044 | 0.212 | |||
E - wave deceleration time (ms) | |||||
Baseline | 235.11 ± 73.97 | 240 (180 - 280) | 207.69 ± 79.97 | 198 (148 - 238.5) | 0.039b
|
6 months | 264.51 ± 72.84 | 250 (218.5 - 300) | 251.82 ± 66.02 | 260 (190 - 295) | 0.755b
|
p-value* | <0.001 | <0.001 | |||
IVRT (ms) | |||||
Baseline | 99.09 ± 26.85 | 100 (80 - 120) | 73.4 ± 33.91 | 70 (50 - 100) | 0.001a
|
6 months | 116.43 ± 20.41 | 110 (100 - 130) | 102.19 ± 28.93 | 100 (82.5 - 127.5) | 0.034a
|
p-value** | 0.049 | <0.001 | |||
e’ (cm/s) | |||||
Baseline | 4.77 ± 1.8 | 4.4 (3.6 - 5.8) | 5.56 ± 2.55 | 5 (4.1 - 6.1) | 0.157b
|
6 months | 5.59 ± 1.52 | 5.4 (4.6 - 6.73) | 7 ± 3.07 | 6.1 (4.78 - 8.7) | 0.033a
|
p-value* | 0.005 | 0.495 | |||
E/
e’
| |||||
Baseline | 18.62 ± 7.11 | 16.9 (13.27 - 23.68) | 23.55 ± 10.88 | 25.36 (15.99 - 30.78) | 0.024b
|
6 months | 16.73 ± 5.96 | 15.75 (13.02 - 19.86) | 16.36 ± 10.77 | 11.72 (8.33 - 23.06) | 0.153b
|
p-value* | 0.096 | 0.177 |
SAVR (n = 45) | TAVI (n = 42) | SAVR vs TAVIp-value* | |||
---|---|---|---|---|---|
mean ± SD | Me (P25-P75) | mean ± SD | Me (P25-P75) | ||
LVEDVi
(ml/
m
2
)
| |||||
Baseline | 61.77 ± 21.81 | 59 (43.49 - 75.58) | 46.29 ± 13.47 | 46.59 (34.44 - 55.74) | 0.007 |
6 months | 51.28 ± 16.63 | 47.64 (38.69 - 59.1) | 42.07 ± 12.87 | 38.89 (33.58 - 48.67) | 0.030 |
p-value** | 0.001 | 0.173 | |||
LVESVi
(ml/
m
2
)
| |||||
Baseline | 27.32 ± 14.68 | 21.7 (16.56 - 34.86) | 20.91 ± 9.81 | 18.54 (13.98 - 28.44) | 0.115 |
6 months | 21.17 ± 11.46 | 19.54 (13.55 - 24.99) | 16.29 ± 7.99 | 13.56 (10.68 - 23.01) | 0.074 |
p-value** | 0.002 | 0.004 | |||
EF (%)
| |||||
Baseline | 57.63 ± 9.38 | 60.1 (54.8 - 63.5) | 55.73 ± 10.15 | 55.45 (49.45 - 59.83) | 0.079 |
6 months | 61.28 ± 8.98 | 61.7 (58.55 - 66.95) | 61.27 ± 11.35 | 61 (53.5 - 70.2) | 0.841 |
p-value** | 0.037 | 0.005 | |||
LVMI (
g/
m
2
)
| |||||
Baseline | 135.3 ± 37.5 | 120.1 (108.4 - 160.2) | 137.46 ± 47.76 | 123.13 (97.5 - 173.89) | 0.877 |
6 months | 119.5 ± 36.8 | 110.7 (96.5 - 128.0) | 124.44 ± 44.55 | 112.53 (98.75 - 155) | 0.588 |
p-value** | 0.002 | 0.537 | |||
LVMI/
LVDVI
| |||||
Baseline | 2.49 ± 0.81 | 2.35 (1.84 - 2.96) | 3.48 ± 1.7 | 3 (2.05 - 4.4) | 0.038 |
6 months | 2.46 ± 0.68 | 2.56 (1.9 - 2.92) | 3.01 ± 1.53 | 2.82 (1.81 - 3.65) | 0.334 |
p-value** | 0.557 | 0.424 | |||
LAVI
(ml/
m
2
)
| |||||
Baseline | 39.94 ± 14.27 | 37.27 (31.15 - 47.99) | 48.42 ± 14.81 | 47.5 (35.36 - 57.14) | 0.008 |
6 months | 38.16 ± 11.9 | 36.17 (30.19 - 45.24) | 40.99 ± 12.7 | 42.63 (29.44 - 50) | 0.425 |
p-value** | 0.465 | 0.006 |
Changes in LV remodeling and functional class after aortic valve replacement
NYHA improvement | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|
OR(95% CI) | p | p | ||
Female gender
[n(%)]
| 0.92 (0.31-2.67) | 0.87 | ||
Age
(years)
| 1.09 (1.01-1.17) | 0.02 | ||
ΔEF (%)
| 0.99 (0.94-1.04) | 0.62 | ||
ΔLVMI
(g/
m
2
)
| 0.99 (0.97-1.01) | 0.49 | ||
ΔLAVI
(ml/
m
2
)
| 1.01 (0.99-1.02) | 0.38 | ||
ΔLVDVI
(ml
/m
2
)
| 0.98 (0.94-1.02) | 0.28 | ||
ΔLVSVI
(ml/
m
2
)
| 0.99 (0.93-1.05) | 0.64 | ||
ΔEAOI (%)
| 8.81 (0.90-86.10) | 0.06 | 3.87 (1.02-14.70) | 0.004 |
ΔE/
e’
| 1.01 (0.94-1.08) | 0.85 | ||
Hypertension [
n(%)]
| 1.70 (0.60-5.15) | 0.35 | ||
Diabetes Mellitus
[n(%)]
| 0.48 (0.15-1.48) | 0.20 | ||
COPD
[n(%)]
| 2.55 (0.75-8.66) | 0.14 | ||
PAD
[n(%)]
| 0.80 (0.22-2.96) | 0.74 | ||
NYHA class ≥ III [n(%)]
| 11.33 (2.93-43.78) | <0.001 | 8.81 (2.13-36.52) | 0.003 |
TAVI [
n(%)]
| 7.08 (1.86-27.04) | 0.004 | ||
Aortic regurgitation 6m [
n(%)]
| 2.35 (0.69-8.03) | 0.17 |