Frequency and Significance of Intravascular Hemolysis Before and After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis
Intravascular hemolysis (IVH) has been identified in patients with surgical prosthetic valves, but few have been reported after transcatheter aortic valve implantation (TAVI). We conducted a prospective analysis of 64 TAVI patients. The hemolysis profiles were collected at baseline and 6 months afte...
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| Veröffentlicht in: | The American journal of cardiology 2018-01, Vol.121 (1), p.69-72 |
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| creator | Ko, Tsung-Yu Lin, Mao-Shin Lin, Lung-Chun Liu, Ying-Ju Yeh, Chih-Fan Huang, Ching-Chang Chen, Ying-Hsien Chen, Yih-Sharng Kao, Hsien-Li |
| description | Intravascular hemolysis (IVH) has been identified in patients with surgical prosthetic valves, but few have been reported after transcatheter aortic valve implantation (TAVI). We conducted a prospective analysis of 64 TAVI patients. The hemolysis profiles were collected at baseline and 6 months after TAVI. The echocardiography was performed at baseline and 6 months after TAVI. There are 14 patients (21.9%) with IVH before and 24(37.5%) after TAVI. The serum haptoglobin values before and 6 months after TAVI are 126.7 ± 75.1 vs 86.3 ± 57.1 mg/dl (p |
| doi_str_mv | 10.1016/j.amjcard.2017.09.023 |
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We conducted a prospective analysis of 64 TAVI patients. The hemolysis profiles were collected at baseline and 6 months after TAVI. The echocardiography was performed at baseline and 6 months after TAVI. There are 14 patients (21.9%) with IVH before and 24(37.5%) after TAVI. The serum haptoglobin values before and 6 months after TAVI are 126.7 ± 75.1 vs 86.3 ± 57.1 mg/dl (p < 0.001). More ≥moderate paravalvular leakage (PVL) (50% vs 7.5%, p < 0.001), bicuspid aortic valve (BAV) (33.3% vs 5.0%, p = 0.004), use of 23 mm prosthesis (29.2% vs 7.5%, p = 0.03), higher residual valvular pressure gradient (17.9 ± 6.8 mm Hg vs 14.7 ± 5.7 mm Hg, p = 0.05), and lower effective orifice area index (1.05 ± 0.21 vs 1.21 ± 0.29, p = 0.03) were observed in patients with post-TAVI IVH. On multivariate regression analysis, BAV and ≥moderate PVL are independently related to post-TAVI IVH. With log-rank test, 1-year rates of readmission due to cardiovascular cause were significantly higher in patients with post-TAVI IVH (odds ratio 4.5; 95% confidence interval 1.3 to 15.6; p = 0.02), after adjusting age and gender. In conclusion, ≥moderate PVL and BAV are predictors of post-TAVI IVH, which is associated with increased cardiovascular readmission in 1-year follow-up.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2017.09.023</identifier><identifier>PMID: 29122274</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Anemia ; Aortic stenosis ; Aortic valve ; Aortic Valve Stenosis - blood ; Aortic Valve Stenosis - complications ; Aortic Valve Stenosis - surgery ; Cohort Studies ; Confidence intervals ; Echocardiography ; Electrocardiography ; Female ; Haptoglobin ; Haptoglobins - metabolism ; Heart ; Hemolysis ; Humans ; Implantation ; Male ; Mercury ; Middle Aged ; Mortality ; Multivariate analysis ; Patient Readmission ; Patients ; Postoperative Complications - epidemiology ; Prospective Studies ; Prostheses ; Prosthetic valves ; Pulmonary arteries ; Regression analysis ; Statistical analysis ; Stenosis ; Surgery ; Transcatheter Aortic Valve Replacement ; Transplants & implants ; Treatment Outcome ; Variables</subject><ispartof>The American journal of cardiology, 2018-01, Vol.121 (1), p.69-72</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>2017. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-362a529be4f3be7bf12a3e3c684b9f18b62076df6f98343fc4963df7edfab1e43</citedby><cites>FETCH-LOGICAL-c393t-362a529be4f3be7bf12a3e3c684b9f18b62076df6f98343fc4963df7edfab1e43</cites><orcidid>0000-0002-5278-3540</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1973119100?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,64361,64363,64365,65309,72215</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29122274$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ko, Tsung-Yu</creatorcontrib><creatorcontrib>Lin, Mao-Shin</creatorcontrib><creatorcontrib>Lin, Lung-Chun</creatorcontrib><creatorcontrib>Liu, Ying-Ju</creatorcontrib><creatorcontrib>Yeh, Chih-Fan</creatorcontrib><creatorcontrib>Huang, Ching-Chang</creatorcontrib><creatorcontrib>Chen, Ying-Hsien</creatorcontrib><creatorcontrib>Chen, Yih-Sharng</creatorcontrib><creatorcontrib>Kao, Hsien-Li</creatorcontrib><title>Frequency and Significance of Intravascular Hemolysis Before and After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Intravascular hemolysis (IVH) has been identified in patients with surgical prosthetic valves, but few have been reported after transcatheter aortic valve implantation (TAVI). We conducted a prospective analysis of 64 TAVI patients. The hemolysis profiles were collected at baseline and 6 months after TAVI. The echocardiography was performed at baseline and 6 months after TAVI. There are 14 patients (21.9%) with IVH before and 24(37.5%) after TAVI. The serum haptoglobin values before and 6 months after TAVI are 126.7 ± 75.1 vs 86.3 ± 57.1 mg/dl (p < 0.001). More ≥moderate paravalvular leakage (PVL) (50% vs 7.5%, p < 0.001), bicuspid aortic valve (BAV) (33.3% vs 5.0%, p = 0.004), use of 23 mm prosthesis (29.2% vs 7.5%, p = 0.03), higher residual valvular pressure gradient (17.9 ± 6.8 mm Hg vs 14.7 ± 5.7 mm Hg, p = 0.05), and lower effective orifice area index (1.05 ± 0.21 vs 1.21 ± 0.29, p = 0.03) were observed in patients with post-TAVI IVH. On multivariate regression analysis, BAV and ≥moderate PVL are independently related to post-TAVI IVH. With log-rank test, 1-year rates of readmission due to cardiovascular cause were significantly higher in patients with post-TAVI IVH (odds ratio 4.5; 95% confidence interval 1.3 to 15.6; p = 0.02), after adjusting age and gender. In conclusion, ≥moderate PVL and BAV are predictors of post-TAVI IVH, which is associated with increased cardiovascular readmission in 1-year follow-up.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia</subject><subject>Aortic stenosis</subject><subject>Aortic valve</subject><subject>Aortic Valve Stenosis - blood</subject><subject>Aortic Valve Stenosis - complications</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Echocardiography</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Haptoglobin</subject><subject>Haptoglobins - metabolism</subject><subject>Heart</subject><subject>Hemolysis</subject><subject>Humans</subject><subject>Implantation</subject><subject>Male</subject><subject>Mercury</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Patient Readmission</subject><subject>Patients</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prospective Studies</subject><subject>Prostheses</subject><subject>Prosthetic valves</subject><subject>Pulmonary arteries</subject><subject>Regression analysis</subject><subject>Statistical analysis</subject><subject>Stenosis</subject><subject>Surgery</subject><subject>Transcatheter Aortic Valve Replacement</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><subject>Variables</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc1qGzEUhUVoSZy0j5Ai6KabmepnPGOtihuaxBBowWm7FBrNVaJhRnIljcEv0ueNHDtZdNOVdOE7517OQeiSkpISWn_uSzX2WoWuZIQ2JRElYfwEzeiiEQUVlL9BM0IIKwStxBk6j7HPI6Xz-hSdMUEZY001Q3-vA_yZwOkdVq7Da_vgrLFaOQ3YG7xyKaitinoaVMC3MPphF23EX8H4AM-SpUkQ8H1QLmqVHmE_LX1IVuNfatgCXo2bQbmkkvUOW4d_5B-4FPFvmx7xGraQnY6KdQLn84J36K1RQ4T3x_cC_bz-dn91W9x9v1ldLe8KzQVPBa-ZmjPRQmV4C01rKFMcuK4XVSsMXbQ1I03dmdqIBa-40ZWoeWca6IxqKVT8An06-G6CzzHEJEcbNQz5YPBTlDTzrGE5uIx-_Aft_RRcvi5TDac5c0IyNT9QOvgYAxi5CXZUYScpkfviZC-Pxcl9cZIImYvLug9H96kdoXtVvTSVgS8HAHIcWwtBRp1j1NDZADrJztv_rHgCVSOukw</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Ko, Tsung-Yu</creator><creator>Lin, Mao-Shin</creator><creator>Lin, Lung-Chun</creator><creator>Liu, Ying-Ju</creator><creator>Yeh, Chih-Fan</creator><creator>Huang, Ching-Chang</creator><creator>Chen, Ying-Hsien</creator><creator>Chen, Yih-Sharng</creator><creator>Kao, Hsien-Li</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5278-3540</orcidid></search><sort><creationdate>20180101</creationdate><title>Frequency and Significance of Intravascular Hemolysis Before and After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis</title><author>Ko, Tsung-Yu ; Lin, Mao-Shin ; Lin, Lung-Chun ; Liu, Ying-Ju ; Yeh, Chih-Fan ; Huang, Ching-Chang ; Chen, Ying-Hsien ; Chen, Yih-Sharng ; Kao, Hsien-Li</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-362a529be4f3be7bf12a3e3c684b9f18b62076df6f98343fc4963df7edfab1e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anemia</topic><topic>Aortic stenosis</topic><topic>Aortic valve</topic><topic>Aortic Valve Stenosis - blood</topic><topic>Aortic Valve Stenosis - complications</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Echocardiography</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Haptoglobin</topic><topic>Haptoglobins - metabolism</topic><topic>Heart</topic><topic>Hemolysis</topic><topic>Humans</topic><topic>Implantation</topic><topic>Male</topic><topic>Mercury</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Patient Readmission</topic><topic>Patients</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Prostheses</topic><topic>Prosthetic valves</topic><topic>Pulmonary arteries</topic><topic>Regression analysis</topic><topic>Statistical analysis</topic><topic>Stenosis</topic><topic>Surgery</topic><topic>Transcatheter Aortic Valve Replacement</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ko, Tsung-Yu</creatorcontrib><creatorcontrib>Lin, Mao-Shin</creatorcontrib><creatorcontrib>Lin, Lung-Chun</creatorcontrib><creatorcontrib>Liu, Ying-Ju</creatorcontrib><creatorcontrib>Yeh, Chih-Fan</creatorcontrib><creatorcontrib>Huang, Ching-Chang</creatorcontrib><creatorcontrib>Chen, Ying-Hsien</creatorcontrib><creatorcontrib>Chen, Yih-Sharng</creatorcontrib><creatorcontrib>Kao, Hsien-Li</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ko, Tsung-Yu</au><au>Lin, Mao-Shin</au><au>Lin, Lung-Chun</au><au>Liu, Ying-Ju</au><au>Yeh, Chih-Fan</au><au>Huang, Ching-Chang</au><au>Chen, Ying-Hsien</au><au>Chen, Yih-Sharng</au><au>Kao, Hsien-Li</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequency and Significance of Intravascular Hemolysis Before and After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>121</volume><issue>1</issue><spage>69</spage><epage>72</epage><pages>69-72</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><abstract>Intravascular hemolysis (IVH) has been identified in patients with surgical prosthetic valves, but few have been reported after transcatheter aortic valve implantation (TAVI). We conducted a prospective analysis of 64 TAVI patients. The hemolysis profiles were collected at baseline and 6 months after TAVI. The echocardiography was performed at baseline and 6 months after TAVI. There are 14 patients (21.9%) with IVH before and 24(37.5%) after TAVI. The serum haptoglobin values before and 6 months after TAVI are 126.7 ± 75.1 vs 86.3 ± 57.1 mg/dl (p < 0.001). More ≥moderate paravalvular leakage (PVL) (50% vs 7.5%, p < 0.001), bicuspid aortic valve (BAV) (33.3% vs 5.0%, p = 0.004), use of 23 mm prosthesis (29.2% vs 7.5%, p = 0.03), higher residual valvular pressure gradient (17.9 ± 6.8 mm Hg vs 14.7 ± 5.7 mm Hg, p = 0.05), and lower effective orifice area index (1.05 ± 0.21 vs 1.21 ± 0.29, p = 0.03) were observed in patients with post-TAVI IVH. On multivariate regression analysis, BAV and ≥moderate PVL are independently related to post-TAVI IVH. With log-rank test, 1-year rates of readmission due to cardiovascular cause were significantly higher in patients with post-TAVI IVH (odds ratio 4.5; 95% confidence interval 1.3 to 15.6; p = 0.02), after adjusting age and gender. In conclusion, ≥moderate PVL and BAV are predictors of post-TAVI IVH, which is associated with increased cardiovascular readmission in 1-year follow-up.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29122274</pmid><doi>10.1016/j.amjcard.2017.09.023</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0002-5278-3540</orcidid></addata></record> |
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| subjects | Aged Aged, 80 and over Anemia Aortic stenosis Aortic valve Aortic Valve Stenosis - blood Aortic Valve Stenosis - complications Aortic Valve Stenosis - surgery Cohort Studies Confidence intervals Echocardiography Electrocardiography Female Haptoglobin Haptoglobins - metabolism Heart Hemolysis Humans Implantation Male Mercury Middle Aged Mortality Multivariate analysis Patient Readmission Patients Postoperative Complications - epidemiology Prospective Studies Prostheses Prosthetic valves Pulmonary arteries Regression analysis Statistical analysis Stenosis Surgery Transcatheter Aortic Valve Replacement Transplants & implants Treatment Outcome Variables |
| title | Frequency and Significance of Intravascular Hemolysis Before and After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis |
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