Impact of Pre-Procedural Left Ventricle Mass Index on Mortality Following TAVI
2Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University
3Cardiology, Hadassah Medical Center, Jerusalem; Affiliated to the Hebrew University of Jerusalem, Jerusalem
4Cardiology, Rabin Medical Center, Petach Tikva, Israel; Affiliated to Sackler Faculty of Medicine, Tel Aviv University
Objectives: To evaluate the association between left ventricle (LV) hypertrophy (LVH) and mortality following transcatheter aortic valve implantation (TAVI).
Background: In contrast to surgical aortic valve replacement studies, LVH had not been clearly associated with mortality following TAVI.
Methods: We performed a retrospective analysis of patients enrolled in the Israeli multicenter TAVI registry between 2012-2016, for whom pre-procedural LV mass index (LVMI) was available. Patients were divided into 3 categories according to LVMI: none or mild LVH (NLVH; <109gr/m2 for females and <132gr/m2 for males), moderate LVH (MLVH; 109-121 gr/m2 for females and 132-148 gr/m2 for males), and severe LVH (SLVH; ≥122gr/m2 for females and ≥149gr/m2 for males).
Results: The cohort consisted of 1559 patients, 46.5% males, with a mean age of 82.2(±6.8) years and mean LVMI of 121(±29)gr/m2. Rates of NLVH, MLVH and SLVH were 807(52%), 279(18%), and 475(30%) of patients, respectively. During a mean follow-up of 2.9(±1.2) years, 426 patients died. For every increase in 10 units of LVMI the risk for mortality increased by 3% (HR 1.03, 95% CI 1-1.06, p=0.047). Compared to NLVH, MLVH and SLVH were associated with increased risk of all-cause mortality in both univariable (HR 1.37, 95%CI 1.05-1.78, p=0.019; and HR 1.32, 95%CI 1.07-1.64, p=0.01; respectively) and multivariable (HR 1.39 95%CI 1.07-1.81, p=0.013; HR 1.29 95%CI 1.04-1.61, p=0.022; respectively) models.
Conclusion: Increased baseline LVMI is associated with long term all-cause mortality in patients with severe aortic stenosis who are referred to TAVI. This parameter should be incorporated into pre-procedural assessment for mortality.
Powered by Eventact EMS