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November 27, 2019

Study Evaluates Association Between Diastolic Dysfunction and Health Status Outcomes in Patients Undergoing TAVR

November 27, 2019—Findings from a study that aimed to assess the association of baseline left ventricular diastolic dysfunction (LVDD) with health status outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) were published by Ali O. Malik, MD, et al in Journal of the American College of Cardiology (JACC): Cardiovascular Interventions.

According to the investigators, the background of the study is that although LVDD in patients with aortic stenosis is associated with higher mortality after TAVR, it is unknown if it is also associated with health status recovery.

The study comprised a cohort of 304 patients with interpretable echocardiograms, who were undergoing TAVR. LVDD was categorized at baseline as absent (grade 0), mild (grade 1), moderate (grade 2), or severe (grade 3). Disease-specific health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire overall summary (KCCQ-OS) score at baseline and at 1- and 12-month follow-up.

As summarized in JACC: Cardiovascular Interventions, the investigators used a linear trend test to assess the association of baseline LVDD with health status at baseline and follow-up after TAVR. The association with health status recovery (change in KCCQ-OS) was examined using a linear mixed model adjusting for baseline KCCQ-OS.

The investigators reported that 24 (7.9%), 54 (17.8%), 186 (61.2%), and 40 (13.2%) patients had LVDD grades of 0, 1, 2, and 3, respectively. Baseline KCCQ-OS was 61.3 ± 22.7, 51.0 ± 26.1, 44.7 ± 25.7, and 44.4 ± 21.9 (P = .004) in patients with LVDD grades of 0, 1, 2, and 3. At 1 and 12 months after TAVR, LVDD was not associated with KCCQ-OS. Recovery in KCCQ-OS after TAVR was substantial and similar in patients across all severities of LVDD.

Although LVDD is associated with health status before TAVR, patients across all severities of LVDD have similar recovery in health status after TAVR, concluded the investigators in JACC: Cardiovascular Interventions.

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