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Effect of Elevated Body Mass Index on Outcomes of Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis

Yoshiyuki Yamashita1, Massimo Baudo1, Serge Sicouri1

  • 1Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Pennsylvania, USA.

Anatolian Journal of Cardiology
|October 7, 2024
PubMed

Insights

The obesity paradox was not observed in transcatheter aortic valve replacement (TAVR) patients. Obesity may worsen outcomes for TAVR patients with chronic lung disease.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Obesity Medicine

Background:

  • The relationship between body mass index (BMI) and cardiovascular risk prediction, including the
  • obesity paradox,
  • is debated.
  • Elevated BMI's impact on outcomes following transcatheter aortic valve replacement (TAVR) for aortic stenosis requires further investigation.

Purpose of the Study:

  • To investigate the effect of elevated body mass index (BMI) on outcomes in patients undergoing transcatheter aortic valve replacement (TAVR).
  • To determine if the
  • obesity paradox,
  • is present in the TAVR population.

Main Methods:

  • Retrospective analysis of 1019 patients with BMI ≥18.5 kg/m2, categorized into normal, overweight, and obese groups.
  • Propensity score matching (1:1) was employed to compare outcomes between normal BMI and overweight/obese groups.
  • Analysis included hemodynamic parameters and all-cause mortality during a median follow-up of 25 months.

Main Results:

  • Overweight and obese patients exhibited higher post-TAVR gradients and lower indexed effective orifice areas compared to normal BMI patients.
  • Overall all-cause mortality was similar across BMI groups (normal, overweight, obese) post-TAVR.
  • Obese patients with moderate/severe chronic lung disease had significantly higher all-cause mortality (HR=3.49, P=.021) compared to normal BMI patients.

Conclusions:

  • The
  • obesity paradox,
  • was not observed in this TAVR cohort.
  • Obesity may be associated with poorer midterm outcomes in TAVR patients who also have significant chronic lung disease.
Abstract

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