Calculated plasma volume status and outcomes in patients undergoing transcatheter aortic valve replacement

• Published in: ESC Heart Failure Vol. 8; no. 3; pp. 1990 - 2001
• Main Authors: Shimura, Tetsuro, Yamamoto, Masanori, Yamaguchi, Ryo, Adachi, Yuya, Sago, Mitsuru, Tsunaki, Tatsuya, Kagase, Ai, Koyama, Yutaka, Otsuka, Toshiaki, Yashima, Fumiaki, Tada, Norio, Naganuma, Toru, Yamawaki, Masahiro, Yamanaka, Futoshi, Shirai, Shinichi, Mizutani, Kazuki, Tabata, Minoru, Ueno, Hiroshi, Takagi, Kensuke, Watanabe, Yusuke, Hayashida, Kentaro
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.06.2021; John Wiley and Sons Inc; Wiley
• Subjects: Aortic Valve Stenosis - diagnosis; Aortic Valve Stenosis - surgery; Heart failure; Hospitalization; Hospitals; Humans; Kidney diseases; Laboratories; Medical prognosis; Medical records; Mortality; OCEAN‐TAVI; Original; Original s; Plasma; Plasma Volume; Plasma volume status; Registries; Software; Standard deviation; Statistical analysis; Survival analysis; TAVR; Transcatheter Aortic Valve Replacement; Treatment Outcome; Variables; Heart failure; Plasma volume status; OCEAN-TAVI; Transcatheter aortic valve replacement; TAVR
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.13270

Aims This study investigated the prognostic value of plasma volume status (PVS) in patients who underwent transcatheter aortic valve replacement (TAVR). Methods and results Plasma volume status was calculated in 2588 patients who underwent TAVR using data from the Japanese multicentre registry. All‐cause mortality and heart failure hospitalization (HFH) within 2 years of TAVR were compared among the PVS quartiles (Q1, PVS < 5.5%; Q2, PVS 5.5–13.5%; Q3, PVS 13.5–21.0%; and Q4, PVS ≥ 21.0%). Subgroups were stratified by the PVS cut‐off value combined with the New York Heart Association (NYHA) class as follows: low PVS with NYHA I/II (n = 959), low PVS with NYHA III/IV (n = 845), high PVS with NYHA I/II (n = 308), and high PVS with NYHA III/IV (n = 476). The cumulative all‐cause mortality and HFH within 2 years of TAVR significantly increased with increasing PVS quartiles [8.5%, 16.8%, 19.2%, and 27.0% (P < 0.001) and 5.8%, 8.7%, 10.3%, and 12.9% (P < 0.001), respectively]. The high‐PVS group regardless of the NYHA class had a higher all‐cause mortality and HFH [9.6%, 18.2%, 24.5%, and 30.4% (P < 0.001) and 6.1%, 10.4%, 14.1%, and 11.3% (P < 0.001)]. In a Cox regression multivariate analysis, the PVS values of Q3 and Q4 had independently increased all‐cause mortality [hazard ratio (HR), 1.50 and 1.64 (P = 0.017 and P = 0.008), respectively], and Q4 had independently increased HFH (HR, 1.98, P = 0.005). The low PVS with NYHA III/IV, high PVS with NYHA I/II, and high PVS with NYHA III/IV also had significantly increased all‐cause mortality [HR, 1.45, 1.73, and 1.86 (P = 0.006, P = 0.002, and P < 0.001), respectively] and HFH [HR, 1.52, 2.21, and 1.70 (P = 0.049, P = 0.002, and P = 0.031), respectively]. Conclusions Plasma volume status is useful for predicting all‐cause mortality and HFH after TAVR.