Short-term effects of transcatheter aortic valve implantation on neurohormonal activation, quality of life and 6-minute walk test in severe and symptomatic aortic stenosis.
OBJECTIVE
This prospective study aimed to determine to what extent clinical symptoms and neurohumoral activation are improved in patients with severe aortic valve stenosis after transcatheter aortic valve implantation (TAVI) with the CoreValve prosthesis.


METHODS
From June 2008 to June 2009 consecutive patients with symptomatic severe aortic valve stenosis (area<1 cm(2)), age>or=75 years with a logistic EuroSCORE >or=15% or age>60 years plus additional specified risk factors were evaluated for TAVI. Examinations of study patients were performed before and 30 days after TAVI and comprised assessment of quality of life (Minnesota living with heart failure questionnaire, [MLHFQ]) 6-minute walk test, measurement of B-type natriuretic peptide and echocardiography. Aortic valve prosthesis was inserted retrograde using a femoral arterial or a subclavian artery approach.


RESULTS
In 44 consecutive patients (mean age 79.1+/-7 years, 50% women, mean left ventricular ejection fraction 55.8+/-8.5%) TAVI was successfully performed. Follow-up 30 days after TAVI showed a significantly improved quality of life (baseline 44+/-19.1 vs 28+/-17.5 MLHFQ Score, p<0.001) and an enhanced distance in the 6-minute walk test (baseline 204+/-103 vs 266+/-123 m, p<0.001). B-type natriuretic peptide levels were reduced (baseline 725+/-837 vs 423+/-320 pg/ml, p=0.005).


CONCLUSIONS
Our preliminary results show a significant clinical benefit and a reduction of neurohormonal activation in patients with severe and symptomatic aortic valve stenosis early after TAVI.
Gotzmann
Michael
M
Medizinische Klinik II-Kardiologie und Angiologie, Berufsgenossenschaftliche Kliniken Bergmannsheil, Klinikum der Ruhr-Universität, Bürkle-de-la-Camp-Platz 1, Bochum D-44789 Germany. michael_gotzmann@web.de
Hehen
Tobias
T
Germing
Alfried
A
Lindstaedt
Michael
M
Yazar
Aydan
A
Laczkovics
Axel
A
Mumme
Achim
A
Mügge
Andreas
A
Bojara
Waldemar
W
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D004812:Epidemiologic Methods; D005080:Exercise Test / Q000379:methods; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000534:rehabilitation; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011788:Quality of Life; D016896:Treatment Outcome; D016138:Walking
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain