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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Cardiac Damage and Quality of Life After Aortic Valve Replacement in the PARTNER Trials

Philippe Généreux1, David J Cohen2, Philippe Pibarot3

  • 1Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey, USA.

Journal of the American College of Cardiology
|February 22, 2023
PubMed

Insights

Extravalvular cardiac damage significantly impacts health status in severe aortic stenosis patients undergoing aortic valve replacement (AVR). Higher damage levels correlate with poorer outcomes and less health status improvement post-AVR.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • Severe aortic stenosis poses risks, with extravalvular cardiac damage exacerbating adverse event rates.
  • Aortic valve replacement (AVR) is a critical intervention for severe aortic stenosis.

Purpose of the Study:

  • To investigate the association between the extent of cardiac damage and patient health status before and after AVR.
  • To evaluate the impact of baseline cardiac damage on 1-year health status outcomes.

Main Methods:

  • Pooled data from the PARTNER 2 and 3 trials (n=1,974) including surgical and transcatheter AVR.
  • Echocardiographic assessment of cardiac damage staged 0-4 at baseline and 1 year.
  • Kansas City Cardiomyopathy Questionnaire Overall Score (KCCQ-OS) used to assess health status.

Main Results:

  • Baseline cardiac damage correlated with lower KCCQ-OS scores at baseline and 1 year post-AVR (P < 0.0001).
  • Increased cardiac damage stages were linked to higher rates of poor outcomes (death or significant KCCQ-OS decline) at 1 year (P < 0.0001).
  • Each 1-stage increase in baseline damage raised the odds of a poor outcome by 24% (P=0.001).

Conclusions:

  • Pre-procedural cardiac damage significantly influences health status outcomes, both cross-sectionally and following AVR.
  • The degree of cardiac damage improvement post-AVR correlates with health status gains.
  • These findings underscore the importance of assessing cardiac damage in AVR candidates.
Abstract

Keywords:
Kansas City Cardiomyopathy Questionnaireaortic stenosisaortic valve replacementcardiac damagequality of lifetranscatheter aortic valve implantationtranscatheter aortic valve replacement

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