Impact of Flow-status on Effective Orifice Area in Transcatheter Heart Valves: a COMPARE-TAVI 1 Substudy.

IF 6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography Pub Date : 2025-10-04 DOI:10.1016/j.echo.2025.09.017

Lytfi Krasniqi, Christian Juhl Terkelsen, Henrik Nissen, Philip Freeman, Christian Alcaraz Frederiksen, Henrik Vase, Kristian Hejlesen, Christian Byskov Fur, Troels Thim, Ashkan Eftekhari, Frederik Uttenthal, Julia Ellert, Nils Sofus Borg Mogensen, Amal Haujir, Evald Høj Christiansen, Jordi Sanchez Dahl

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引用次数: 0

Abstract

Objective: The aim of this study was to study the impact of flow-status on Effective Orifice Area (EOA) in patients treated with the balloon-expandable Myval and Sapien transcatheter heart valves (THVs).

Methods: We collected the core laboratory measured effective orifice area (EOA), mean and peak gradients, Doppler velocity index (DVI) and stroke volume index (SVi) from the 30-day echocardiograms in patients treated with the balloon-expandable Myval and Sapien THVs in the COMPARE-TAVI 1 trial. Patients were stratified according to flow in low-flow (SVi <35 ml/m²) normal-flow (SVi 35-50 ml/m²) and high-flow (SVi >50 ml/m²).

Results: A total of 1031 patients were included in COMPARE-TAVI 1. Myval THVs (20.0mm to 32.0mm) exhibited overall higher mean EOA and lower mean gradients (1.99 ± 0.55 cm², 9.46 ± 3.84 mmHg) compared to Sapien THVs (20-29 mm) (1.81 ± 0.56 cm², 11.47 ± 4.47 mmHg). Compared to normal-flow patients, low-flow exhibited smaller EOA (p<0.001) and lower DVI (p<0.001) in all valve sizes irrespective of THV platform, while high-flow patients had larger EOA (p<0.001) and higher DVI (p<0.001). Female sex was associated with lower stroke volume resulting in lower mean and peak gradients independent of valve size and platform (p<0.001).

Conclusion: The study indicates that EOA may be underestimated after TAVI in patients with low-flow status which can impact assessment of prosthesis patient mismatch.

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经导管心脏瓣膜中流动状态对有效孔面积的影响：一项比较tavi 1亚研究。

目的：研究球囊扩张型Myval和Sapien经导管心脏瓣膜（THVs）治疗患者血流状态对有效孔面积（EOA）的影响。方法：收集在COMPARE-TAVI 1试验中使用球囊可扩张的Myval和Sapien thv治疗的患者30天超声心动图的核心实验室测量的有效孔面积（EOA）、平均梯度和峰值梯度、多普勒速度指数（DVI）和脑卒中容积指数（SVi）。患者按流量分为低流量（SVi 2）、正常流量（SVi 35 ~ 50 ml/m2）和高流量（SVi bb0 ~ 50 ml/m2）。结果：共有1031例患者纳入了COMPARE-TAVI 1。与Sapien THVs (20-29 mm)（1.81±0.56 cm2, 11.47±4.47 mmHg）相比，Myval THVs （20.0 ~ 32.0mm）的平均EOA总体较高，平均梯度较低（1.99±0.55 cm2, 9.46±3.84 mmHg）。与正常流量患者相比，低流量患者表现出更小的EOA (p)。结论：本研究提示低流量患者TAVI术后EOA可能被低估，影响假体患者配错的评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Society of Echocardiography 医学-心血管系统

CiteScore

9.50

自引率

12.30%

发文量

257

审稿时长

66 days

期刊介绍： The Journal of the American Society of Echocardiography(JASE) brings physicians and sonographers peer-reviewed original investigations and state-of-the-art review articles that cover conventional clinical applications of cardiovascular ultrasound, as well as newer techniques with emerging clinical applications. These include three-dimensional echocardiography, strain and strain rate methods for evaluating cardiac mechanics and interventional applications.