title: Impact of restrictive versus obstructive pulmonary function patterns on mortality in patients undergoing transcatheter aortic valve implantation.
abstract: BACKGROUND
  Pulmonary function tests to estimate force vital capacity (FVC) and forced expiratory volume in the first second (FEV1) have increasingly been used in patients evaluated for transcatheter aortic valve implantation (TAVI). The impact of obstructive versus restrictive lung disease on mortality remains unclear. The authors sought to identify differences in survival in patients with 2 distinct pulmonary function patterns (obstruction vs. restriction).
  
  
  METHODS
  The authors retrospectively analyzed all patients with abnormal FEV1 (lower than 80% of predicted) detected on the pulmonary function tests prior to TAVI from May 2011 to November 2014. Patients were divided into a group with obstructive pattern (FEV1/FVC<70% of predicted) and a group with restrictive pattern (FEV1/FVC>70% of predicted). Cox proportional hazards regression was used to explore the impact of FEV1 on mortality.
  
  
  RESULTS
  A total of 94 patients were included in this analysis. Forty-one percent (n=38) had obstructive pattern, and 59% (n=56) had restrictive pattern. FEV1 values were similar between both groups (43±19 vs. 42±26, p=0.89). Both groups had similar rates of in-hospital, 30-day, and 1-year mortality. FEV1 was not a correlate for 1-year mortality. Patients with pulmonary obstructive and restrictive patters had similar rates of mortality. Moreover, FEV1 value is not a correlate for 1-year mortality.
  
  
  CONCLUSIONS
  In the current era, the pattern on pulmonary function tests and FEV1 values should not influence the decision on whom to offer a transcatheter option for their severe valvular disease.
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Ricardo O
authors.initials: RO
authors.lastname: Escárcega
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Arpi
authors.initials: A
authors.lastname: Tavil-Shatelyan
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Youstina
authors.initials: Y
authors.lastname: Daoud
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Edward
authors.initials: E
authors.lastname: Koifman
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Sarkis
authors.initials: S
authors.lastname: Kiramijyan
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Jiaxiang
authors.initials: J
authors.lastname: Gai
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC. Electronic address: ron.waksman@medstar.net.
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D018572:Disease-Free Survival; D005260:Female; D005541:Forced Expiratory Volume; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000503:physiopathology*; D008297:Male; D018579:Patient Selection; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013147:Spirometry; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity
keywords: COPD; Obstructive; Restrictive; TAVR