Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Aims: Doppler mean gradient (MG) can underestimate aortic stenosis (AS) severity in patients with atrial fibrillation (AF) compared with patients with sinus rhythm (SR), potentially delaying intervention in AF. This study compared outcomes in patients with AF and SR following transcatheter aortic valve replacement (TAVR) and investigated delay in TAVR based on computed tomography aortic valve calcium score (AVCS).
Methods And Results: Patients who underwent TAVR from 2013 to 2017 for native valve severe AS were identified from an institutional database. Baseline characteristics and overall survival were compared between those with SR and AF. There were 820 patients (mean age 81 years; 41.6% females) included in this study. AF was present in 356 patients. Patients with AF were older (82.2 vs. 80.5, P = 0.003) and had a lower MG compared with patients with SR (42.0 vs. 44.9, P = 0.002) with similar indexed aortic valve area (0.4 vs. 0.4, P = 0.17). Median AVCS was higher in AF (males: AF 2850.0 vs. SR 2561.0, P = 0.044; females: AF 1942.0 vs. SR 1610.5, P = 0.025). Projected AVCS, assuming the same age of diagnosis, was similar between AF and SR. Median survival post-TAVR was worse in AF compared with SR (3.2 vs. 5.4 years, log rank P < 0.001). AF, lower MG, higher right ventricular systolic pressure, dialysis, diabetes, and significant tricuspid regurgitation were associated with higher mortality (P < 0.05 for all).
Conclusion: Older age and higher AVCS in patients with AF compared with those with SR suggest that AS was both underestimated and more advanced at TAVR referral.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ehjci/jeae113 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Preoperative Echocardiography in Pectus Excavatum: High Rate of Incidental Findings, Low but Clinically Important Yield of Significant Anomalies.
J Pediatr Surg
September 2025
University of Utah, Department of Surgery, Division of Pediatric Surgery. Electronic address:
Background: Routine preoperative echocardiograms (ECHOs) are frequently obtained in patients undergoing minimally invasive repair of pectus excavatum (MIRPE), but the benefit and necessity of preoperative screening remain debated. In this study, we sought to quantify the proportion of preoperative ECHOs that had clinically significant findings.
Methods: We conducted a retrospective review of 255 patients who underwent MIRPE at a single pediatric referral center from 2018 to 2023.
Oral anticoagulation in patients with atrial fibrillation and heart valve prosthesis: a substudy from the LAAOS III Trial.
J Thorac Cardiovasc Surg
September 2025
Population Health Research Institute, Hamilton Health Sciences, McMaster University, Ontario, Canada.
Objective: Societal guidelines recommend vitamin K antagonists (VKAs) for atrial fibrillation patients with recent biological valve implantation, but the safety and efficacy of direct oral anticoagulants (DOACs) in this setting remain uncertain, especially in the early postoperative period. This substudy of the Left Atrial Appendage Occlusion Study (LAAOS) III trial aimed to compare thromboembolic and bleeding outcomes in patients discharged on VKAs versus DOACs after bioprosthesis implantation or mitral valve repair.
Methods: A total of 2,645 patients were included, with 461 discharged on DOACs and 2184 on VKAs.
Clinical outcomes following TAVR for patients with low and very low gradient aortic stenosis.
Prog Cardiovasc Dis
September 2025
Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address:
Objectives: This study explores the impact of lower baseline aortic valve (AV) mean gradients on the clinical outcomes of patients with low-gradient aortic stenosis (LG AS) post-transcatheter aortic valve replacement (TAVR). Additionally, the study aims to understand the predictors of a lower baseline AV mean gradient (MG).
Background: Reduced left ventricular ejection fraction (LVEF) and low-flow states are known to correlate with worse clinical outcomes.
Automated detection of pediatric congenital heart disease from phonocardiograms using deep and handcrafted feature fusion.
Comput Biol Med
September 2025
Electrical and Computer System Engineering, Monash University, Clayton, Melbourne, 3800, VIC, Australia.
Congenital heart disease (CHD) is the most common type of birth defect, impacting about 1% of live births worldwide. Echocardiography, the gold-standard diagnostic method, is costly and inaccessible in low-resource settings. Diagnosis is delayed due to limited skilled experts, whose ability to interpret pathological patterns varies significantly, causing inter- and intra-clinician variability.
View Article and Find Full Text PDFClinical and Laboratory Predictors for the Development of Heart Valve Diseases in Chronic Kidney Disease: A Systematic Review.
Arq Bras Cardiol
September 2025
Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brasil.
Background: Chronic kidney disease (CKD) is associated with a higher prevalence of valvular diseases and increased mortality from cardiovascular causes. Factors that influence the genesis of cardiac valve calcification (CVC) in these patients are not well-defined.
Objective: To determine the risk factors for valvular calcification in patients with CKD.