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Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic
INTRODUCTION: Delays in the diagnosis and referral of aortic stenosis (AS) during the coronavirus disease 2019 (COVID-19) pandemic may have affected the haemodynamic status of AS patients. We aimed to compare clinical and haemodynamic characteristics of severe AS patients referred for transcatheter...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bohn Stafleu van Loghum
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516812/ https://www.ncbi.nlm.nih.gov/pubmed/37498468 http://dx.doi.org/10.1007/s12471-023-01795-y |
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author | Ooms, Joris F. Hokken, Thijmen W. Adrichem, Rik Gunes, Dilay de Ronde-Tillmans, Marjo Kardys, Isabella Goudzwaard, Jeannette Mattace-Raso, Francesco Nuis, Rutger-Jan Daemen, Joost Van Mieghem, Nicolas M. |
author_facet | Ooms, Joris F. Hokken, Thijmen W. Adrichem, Rik Gunes, Dilay de Ronde-Tillmans, Marjo Kardys, Isabella Goudzwaard, Jeannette Mattace-Raso, Francesco Nuis, Rutger-Jan Daemen, Joost Van Mieghem, Nicolas M. |
author_sort | Ooms, Joris F. |
collection | PubMed |
description | INTRODUCTION: Delays in the diagnosis and referral of aortic stenosis (AS) during the coronavirus disease 2019 (COVID-19) pandemic may have affected the haemodynamic status of AS patients. We aimed to compare clinical and haemodynamic characteristics of severe AS patients referred for transcatheter aortic valve implantation (TAVI) or balloon aortic valvuloplasty (BAV) before the pandemic versus two subsequent periods. METHODS: This study compared three 1‑year historical cohorts: a pre-COVID-19 group (PCOV), a 1st-year COVID-19 group (COV-Y1) and a 2nd-year COVID-19 group (COV-Y2). The main parameters were baseline New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP). Demographics, procedural characteristics and 30-day clinical outcomes were assessed. The transition time between heart team decision and TAVI was examined. Pairwise group comparisons were performed (PCOV vs COV-1Y and COV-1Y vs COV-2Y). RESULTS: A total of 720 patients were included with 266, 249 and 205 patients in the PCOV, COV-Y1 and COV-Y2 groups, respectively. BAV was performed in 28 patients (4%). NYHA class did not differ across the cohorts. Compared to PCOV, LVEF was slightly lower in COV-Y1 (58% (49–60%) vs 57% (45–60%), p = 0.03); no difference was observed when comparing COV-Y1 and COV-Y2. LVEDP was higher in COV-Y1 than in PCOV (20 mm Hg (16–26 mm Hg) vs 17 mm Hg (13–24 mm Hg), p = 0.01). No difference was found when comparing LVEDP between COV-Y1 and COV-Y2. Thirty-day mortality did not differ between groups. Transition time was reduced in the COVID era. Duration of hospital stay declined over the study period. CONCLUSIONS: Patients undergoing TAVI during the COVID-19 pandemic had more advanced AS illustrated by lower LVEF and higher LVEDP, but there were no differences in clinical outcome. The TAVI pathway became more efficient. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12471-023-01795-y) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-10516812 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-105168122023-09-24 Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic Ooms, Joris F. Hokken, Thijmen W. Adrichem, Rik Gunes, Dilay de Ronde-Tillmans, Marjo Kardys, Isabella Goudzwaard, Jeannette Mattace-Raso, Francesco Nuis, Rutger-Jan Daemen, Joost Van Mieghem, Nicolas M. Neth Heart J Original Article INTRODUCTION: Delays in the diagnosis and referral of aortic stenosis (AS) during the coronavirus disease 2019 (COVID-19) pandemic may have affected the haemodynamic status of AS patients. We aimed to compare clinical and haemodynamic characteristics of severe AS patients referred for transcatheter aortic valve implantation (TAVI) or balloon aortic valvuloplasty (BAV) before the pandemic versus two subsequent periods. METHODS: This study compared three 1‑year historical cohorts: a pre-COVID-19 group (PCOV), a 1st-year COVID-19 group (COV-Y1) and a 2nd-year COVID-19 group (COV-Y2). The main parameters were baseline New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP). Demographics, procedural characteristics and 30-day clinical outcomes were assessed. The transition time between heart team decision and TAVI was examined. Pairwise group comparisons were performed (PCOV vs COV-1Y and COV-1Y vs COV-2Y). RESULTS: A total of 720 patients were included with 266, 249 and 205 patients in the PCOV, COV-Y1 and COV-Y2 groups, respectively. BAV was performed in 28 patients (4%). NYHA class did not differ across the cohorts. Compared to PCOV, LVEF was slightly lower in COV-Y1 (58% (49–60%) vs 57% (45–60%), p = 0.03); no difference was observed when comparing COV-Y1 and COV-Y2. LVEDP was higher in COV-Y1 than in PCOV (20 mm Hg (16–26 mm Hg) vs 17 mm Hg (13–24 mm Hg), p = 0.01). No difference was found when comparing LVEDP between COV-Y1 and COV-Y2. Thirty-day mortality did not differ between groups. Transition time was reduced in the COVID era. Duration of hospital stay declined over the study period. CONCLUSIONS: Patients undergoing TAVI during the COVID-19 pandemic had more advanced AS illustrated by lower LVEF and higher LVEDP, but there were no differences in clinical outcome. The TAVI pathway became more efficient. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12471-023-01795-y) contains supplementary material, which is available to authorized users. Bohn Stafleu van Loghum 2023-07-27 2023-10 /pmc/articles/PMC10516812/ /pubmed/37498468 http://dx.doi.org/10.1007/s12471-023-01795-y Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Ooms, Joris F. Hokken, Thijmen W. Adrichem, Rik Gunes, Dilay de Ronde-Tillmans, Marjo Kardys, Isabella Goudzwaard, Jeannette Mattace-Raso, Francesco Nuis, Rutger-Jan Daemen, Joost Van Mieghem, Nicolas M. Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic |
title | Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic |
title_full | Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic |
title_fullStr | Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic |
title_full_unstemmed | Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic |
title_short | Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic |
title_sort | changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the covid-19 pandemic |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516812/ https://www.ncbi.nlm.nih.gov/pubmed/37498468 http://dx.doi.org/10.1007/s12471-023-01795-y |
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