Short-term Echocardiography and Blood NT-proBNP Changes in Aortic Stenosis Patients After Transcatheter Aortic Valve Replacement
10.3969/j.issn.1000-3614.2017.06.011
- VernacularTitle:主动脉瓣狭窄患者经导管主动脉瓣置换术后短期超声心动图和血N末端B型利钠肽原浓度变化特点分析
- Author:
Zhenyan ZHAO
;
Guangyuan SONG
;
Wenjia ZHANG
;
Qian ZHANG
;
Guannan NIU
;
Zheng ZHOU
;
Hao ZHANG
;
Hanjun PEI
;
Jiande WANG
;
Minghu XIAO
;
Yuejin YANG
;
Yongjian WU
- Keywords:
Aortic valve stenosis;
Heart valve prosthesis implantation;
Echocardiography
- From:
Chinese Circulation Journal
2017;32(6):575-579
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the cardiac function and outcomes in patients of aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR) within 6 months in order to provide the guidance for clinical treatment. Methods: A total of 49 consecutive severe AS patients with surgical contradiction or STS high risk score and received successful TAVR in our hospital from 2013-12 to 2015-12 were studied. Echocardiography and blood levels of NT-proBNP were examined at pre- and 1 month, 6 months after TAVR. Left ventricular ejection fraction (LVEF), aortic valve mean gradient (MG), peak gradient (PG) and peak velocity (PV) were recorded. Based on pre-operative LVEF, the patients were divided into 2 groups: Cardiac dysfunction group, LVEF<50%,n=15 (30.6%) and Normal cardiac function group, LVEF≥50%, n=34 (69.4%). Post-operative cardiac function and blood levels of NT-proBNP were compared between 2 groups. Results: In all 49 patients, the following parameters were significantly improved within 7 days after TAVR: LVEF (56.0±14.6) % vs (52.5±13.8)%, MG (11±5) mmHg vs (58±18) mmHg, PG (21.7±9.5) mmHg vs (93.0±28.6) mmHg, PV (2.3±0.5) m/s vs (4.8±0.7) m/s, blood NT-proBNP level [1831 (1098-3363)] pg/ml vs [3842 (1763-8664)] pg/ml and aortic valve area (1.57±0.43) cm2 vs (0.58±0.23) cm2 allP<0.05. Within 6 months after TAVR, LVEF was continuously increasing especially in Cardiac dysfunction group; MG, PV and NT-proBNP level were continuously decreasing, NYHA grade was continuously improving, allP<0.05. Conclusion: TAVR was an effective treatment in AS patients with surgical contradiction or STS high risk score; it may continuously improve cardiac function, especially in patients with left heart dysfunction.
