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The impact of subclinical congestion on the outcome of patients undergoing transcatheter aortic valve implantation
Background We investigated the impact of an elevated plasma volume status (PVS) in patients undergoing TAVI on early clinical safety and mortality and assessed the prognostic utility of PVS for outcome prediction. Materials and methods We retrospectively calculated the PVS in 652 patients undergoing...
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| Published in: | European journal of clinical investigation 2020-08, Vol.50 (8), p.e13251-n/a |
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| container_title | European journal of clinical investigation |
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| creator | Adlbrecht, Christopher Piringer, Felix Resar, Jon Watzal, Victoria Andreas, Martin Strouhal, Andreas Hasan, Waseem Geisler, Daniela Weiss, Gabriel Grabenwöger, Martin Delle‐Karth, Georg Mach, Markus |
| description | Background
We investigated the impact of an elevated plasma volume status (PVS) in patients undergoing TAVI on early clinical safety and mortality and assessed the prognostic utility of PVS for outcome prediction.
Materials and methods
We retrospectively calculated the PVS in 652 patients undergoing TAVI between 2009 and 2018 at two centres. They were then categorized into two groups depending on their preoperative PVS (PVS ≤−4; n = 257 vs PVS>−4; n = 379). Relative PVS was derived by subtracting calculated ideal (iPVS = c × weight) from actual plasma volume (aPVS = (1 − haematocrit) × (a + (b × weight in kg)).
Results
The need for renal replacement therapy (1 (0.4%) vs 17 (4.5%); P = .001), re‐operation for noncardiac reasons (9 (3.5%) vs 32 (8.4%); P = .003), re‐operation for bleeding (9 (3.5%) vs 27 (7.1%); P = .037) and major bleeding (14 (5.4%) vs 37 (9.8%); P = .033) were significantly higher in patients with a PVS>−4. The composite 30‐day early safety endpoint (234 (91.1%) vs 314 (82.8%); P = .002) confirms that an increased preoperative PVS is associated with a worse overall outcome after TAVI.
Conclusions
An elevated PVS (>−4) as a marker for congestion is associated with significantly worse outcome after TAVI and therefore should be incorporated in preprocedural risk stratification. |
| doi_str_mv | 10.1111/eci.13251 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7507141</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2428433309</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4431-f26678fdf96551c67c681e5ad2a8281b12d90dfb376f4a99494a0458e878eea53</originalsourceid><addsrcrecordid>eNp1kU9rFDEYh4Modq0e_AIS8KKHafN_kosgS9VCwUs9h3czmW3KTLImmS399ma7tahgEsghD0_e9_0h9JaSM9rWuXfhjHIm6TO0olzJjnHFnqMVIVR0zPTsBL0q5ZYQohv2Ep1w1jYnfIXy9Y3HYd6BqziNuCwbN4UYHEzYpbj1pYYUcTu1cWmpLs3-AO6gBh9rwUscfN6mELe4ZojFQSOrzxhSrsHhPUz7hx8miBUOttfoxQhT8W8e71P048vF9fpbd_X96-X681XnhOC0G5lSvR6H0SgpqVO9U5p6CQMDzTTdUDYYMowb3qtRgDHCCCBCaq977T1Ifoo-Hb27ZTP7wbVyM0x2l8MM-d4mCPbvlxhu7DbtbS9JTwVtgg-Pgpx-Lm0Udg7F-al14tNSLONGMGmYUQ19_w96m5YcW3uWCaYFb9M2jfp4pFxOpWQ_PhVDiT0kaVuS9iHJxr77s_on8nd0DTg_Andh8vf_N9mL9eVR-Qtouqnx</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2428433309</pqid></control><display><type>article</type><title>The impact of subclinical congestion on the outcome of patients undergoing transcatheter aortic valve implantation</title><source>Wiley</source><creator>Adlbrecht, Christopher ; Piringer, Felix ; Resar, Jon ; Watzal, Victoria ; Andreas, Martin ; Strouhal, Andreas ; Hasan, Waseem ; Geisler, Daniela ; Weiss, Gabriel ; Grabenwöger, Martin ; Delle‐Karth, Georg ; Mach, Markus</creator><creatorcontrib>Adlbrecht, Christopher ; Piringer, Felix ; Resar, Jon ; Watzal, Victoria ; Andreas, Martin ; Strouhal, Andreas ; Hasan, Waseem ; Geisler, Daniela ; Weiss, Gabriel ; Grabenwöger, Martin ; Delle‐Karth, Georg ; Mach, Markus</creatorcontrib><description>Background
We investigated the impact of an elevated plasma volume status (PVS) in patients undergoing TAVI on early clinical safety and mortality and assessed the prognostic utility of PVS for outcome prediction.
Materials and methods
We retrospectively calculated the PVS in 652 patients undergoing TAVI between 2009 and 2018 at two centres. They were then categorized into two groups depending on their preoperative PVS (PVS ≤−4; n = 257 vs PVS>−4; n = 379). Relative PVS was derived by subtracting calculated ideal (iPVS = c × weight) from actual plasma volume (aPVS = (1 − haematocrit) × (a + (b × weight in kg)).
Results
The need for renal replacement therapy (1 (0.4%) vs 17 (4.5%); P = .001), re‐operation for noncardiac reasons (9 (3.5%) vs 32 (8.4%); P = .003), re‐operation for bleeding (9 (3.5%) vs 27 (7.1%); P = .037) and major bleeding (14 (5.4%) vs 37 (9.8%); P = .033) were significantly higher in patients with a PVS>−4. The composite 30‐day early safety endpoint (234 (91.1%) vs 314 (82.8%); P = .002) confirms that an increased preoperative PVS is associated with a worse overall outcome after TAVI.
Conclusions
An elevated PVS (>−4) as a marker for congestion is associated with significantly worse outcome after TAVI and therefore should be incorporated in preprocedural risk stratification.</description><identifier>ISSN: 0014-2972</identifier><identifier>EISSN: 1365-2362</identifier><identifier>DOI: 10.1111/eci.13251</identifier><identifier>PMID: 32323303</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aorta ; Aortic valve ; Bleeding ; cardiac decompensation ; Congestion ; Heart valves ; Hematocrit ; Implantation ; Mathematical analysis ; Original Paper ; Original Papers ; plasma volume ; Safety ; TAVR ; transcatheter aortic valve implantation ; Weight</subject><ispartof>European journal of clinical investigation, 2020-08, Vol.50 (8), p.e13251-n/a</ispartof><rights>2020 The Authors. published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.</rights><rights>2020 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4431-f26678fdf96551c67c681e5ad2a8281b12d90dfb376f4a99494a0458e878eea53</citedby><cites>FETCH-LOGICAL-c4431-f26678fdf96551c67c681e5ad2a8281b12d90dfb376f4a99494a0458e878eea53</cites><orcidid>0000-0002-4740-0197 ; 0000-0003-4955-2714 ; 0000-0002-7252-7130 ; 0000-0003-4950-5432 ; 0000-0002-3184-4914 ; 0000-0001-7019-8575</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32323303$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adlbrecht, Christopher</creatorcontrib><creatorcontrib>Piringer, Felix</creatorcontrib><creatorcontrib>Resar, Jon</creatorcontrib><creatorcontrib>Watzal, Victoria</creatorcontrib><creatorcontrib>Andreas, Martin</creatorcontrib><creatorcontrib>Strouhal, Andreas</creatorcontrib><creatorcontrib>Hasan, Waseem</creatorcontrib><creatorcontrib>Geisler, Daniela</creatorcontrib><creatorcontrib>Weiss, Gabriel</creatorcontrib><creatorcontrib>Grabenwöger, Martin</creatorcontrib><creatorcontrib>Delle‐Karth, Georg</creatorcontrib><creatorcontrib>Mach, Markus</creatorcontrib><title>The impact of subclinical congestion on the outcome of patients undergoing transcatheter aortic valve implantation</title><title>European journal of clinical investigation</title><addtitle>Eur J Clin Invest</addtitle><description>Background
We investigated the impact of an elevated plasma volume status (PVS) in patients undergoing TAVI on early clinical safety and mortality and assessed the prognostic utility of PVS for outcome prediction.
Materials and methods
We retrospectively calculated the PVS in 652 patients undergoing TAVI between 2009 and 2018 at two centres. They were then categorized into two groups depending on their preoperative PVS (PVS ≤−4; n = 257 vs PVS>−4; n = 379). Relative PVS was derived by subtracting calculated ideal (iPVS = c × weight) from actual plasma volume (aPVS = (1 − haematocrit) × (a + (b × weight in kg)).
Results
The need for renal replacement therapy (1 (0.4%) vs 17 (4.5%); P = .001), re‐operation for noncardiac reasons (9 (3.5%) vs 32 (8.4%); P = .003), re‐operation for bleeding (9 (3.5%) vs 27 (7.1%); P = .037) and major bleeding (14 (5.4%) vs 37 (9.8%); P = .033) were significantly higher in patients with a PVS>−4. The composite 30‐day early safety endpoint (234 (91.1%) vs 314 (82.8%); P = .002) confirms that an increased preoperative PVS is associated with a worse overall outcome after TAVI.
Conclusions
An elevated PVS (>−4) as a marker for congestion is associated with significantly worse outcome after TAVI and therefore should be incorporated in preprocedural risk stratification.</description><subject>Aorta</subject><subject>Aortic valve</subject><subject>Bleeding</subject><subject>cardiac decompensation</subject><subject>Congestion</subject><subject>Heart valves</subject><subject>Hematocrit</subject><subject>Implantation</subject><subject>Mathematical analysis</subject><subject>Original Paper</subject><subject>Original Papers</subject><subject>plasma volume</subject><subject>Safety</subject><subject>TAVR</subject><subject>transcatheter aortic valve implantation</subject><subject>Weight</subject><issn>0014-2972</issn><issn>1365-2362</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kU9rFDEYh4Modq0e_AIS8KKHafN_kosgS9VCwUs9h3czmW3KTLImmS399ma7tahgEsghD0_e9_0h9JaSM9rWuXfhjHIm6TO0olzJjnHFnqMVIVR0zPTsBL0q5ZYQohv2Ep1w1jYnfIXy9Y3HYd6BqziNuCwbN4UYHEzYpbj1pYYUcTu1cWmpLs3-AO6gBh9rwUscfN6mELe4ZojFQSOrzxhSrsHhPUz7hx8miBUOttfoxQhT8W8e71P048vF9fpbd_X96-X681XnhOC0G5lSvR6H0SgpqVO9U5p6CQMDzTTdUDYYMowb3qtRgDHCCCBCaq977T1Ifoo-Hb27ZTP7wbVyM0x2l8MM-d4mCPbvlxhu7DbtbS9JTwVtgg-Pgpx-Lm0Udg7F-al14tNSLONGMGmYUQ19_w96m5YcW3uWCaYFb9M2jfp4pFxOpWQ_PhVDiT0kaVuS9iHJxr77s_on8nd0DTg_Andh8vf_N9mL9eVR-Qtouqnx</recordid><startdate>202008</startdate><enddate>202008</enddate><creator>Adlbrecht, Christopher</creator><creator>Piringer, Felix</creator><creator>Resar, Jon</creator><creator>Watzal, Victoria</creator><creator>Andreas, Martin</creator><creator>Strouhal, Andreas</creator><creator>Hasan, Waseem</creator><creator>Geisler, Daniela</creator><creator>Weiss, Gabriel</creator><creator>Grabenwöger, Martin</creator><creator>Delle‐Karth, Georg</creator><creator>Mach, Markus</creator><general>Blackwell Publishing Ltd</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4740-0197</orcidid><orcidid>https://orcid.org/0000-0003-4955-2714</orcidid><orcidid>https://orcid.org/0000-0002-7252-7130</orcidid><orcidid>https://orcid.org/0000-0003-4950-5432</orcidid><orcidid>https://orcid.org/0000-0002-3184-4914</orcidid><orcidid>https://orcid.org/0000-0001-7019-8575</orcidid></search><sort><creationdate>202008</creationdate><title>The impact of subclinical congestion on the outcome of patients undergoing transcatheter aortic valve implantation</title><author>Adlbrecht, Christopher ; Piringer, Felix ; Resar, Jon ; Watzal, Victoria ; Andreas, Martin ; Strouhal, Andreas ; Hasan, Waseem ; Geisler, Daniela ; Weiss, Gabriel ; Grabenwöger, Martin ; Delle‐Karth, Georg ; Mach, Markus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4431-f26678fdf96551c67c681e5ad2a8281b12d90dfb376f4a99494a0458e878eea53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aorta</topic><topic>Aortic valve</topic><topic>Bleeding</topic><topic>cardiac decompensation</topic><topic>Congestion</topic><topic>Heart valves</topic><topic>Hematocrit</topic><topic>Implantation</topic><topic>Mathematical analysis</topic><topic>Original Paper</topic><topic>Original Papers</topic><topic>plasma volume</topic><topic>Safety</topic><topic>TAVR</topic><topic>transcatheter aortic valve implantation</topic><topic>Weight</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adlbrecht, Christopher</creatorcontrib><creatorcontrib>Piringer, Felix</creatorcontrib><creatorcontrib>Resar, Jon</creatorcontrib><creatorcontrib>Watzal, Victoria</creatorcontrib><creatorcontrib>Andreas, Martin</creatorcontrib><creatorcontrib>Strouhal, Andreas</creatorcontrib><creatorcontrib>Hasan, Waseem</creatorcontrib><creatorcontrib>Geisler, Daniela</creatorcontrib><creatorcontrib>Weiss, Gabriel</creatorcontrib><creatorcontrib>Grabenwöger, Martin</creatorcontrib><creatorcontrib>Delle‐Karth, Georg</creatorcontrib><creatorcontrib>Mach, Markus</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley-Blackwell Backfiles (Open access)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of clinical investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adlbrecht, Christopher</au><au>Piringer, Felix</au><au>Resar, Jon</au><au>Watzal, Victoria</au><au>Andreas, Martin</au><au>Strouhal, Andreas</au><au>Hasan, Waseem</au><au>Geisler, Daniela</au><au>Weiss, Gabriel</au><au>Grabenwöger, Martin</au><au>Delle‐Karth, Georg</au><au>Mach, Markus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of subclinical congestion on the outcome of patients undergoing transcatheter aortic valve implantation</atitle><jtitle>European journal of clinical investigation</jtitle><addtitle>Eur J Clin Invest</addtitle><date>2020-08</date><risdate>2020</risdate><volume>50</volume><issue>8</issue><spage>e13251</spage><epage>n/a</epage><pages>e13251-n/a</pages><issn>0014-2972</issn><eissn>1365-2362</eissn><abstract>Background
We investigated the impact of an elevated plasma volume status (PVS) in patients undergoing TAVI on early clinical safety and mortality and assessed the prognostic utility of PVS for outcome prediction.
Materials and methods
We retrospectively calculated the PVS in 652 patients undergoing TAVI between 2009 and 2018 at two centres. They were then categorized into two groups depending on their preoperative PVS (PVS ≤−4; n = 257 vs PVS>−4; n = 379). Relative PVS was derived by subtracting calculated ideal (iPVS = c × weight) from actual plasma volume (aPVS = (1 − haematocrit) × (a + (b × weight in kg)).
Results
The need for renal replacement therapy (1 (0.4%) vs 17 (4.5%); P = .001), re‐operation for noncardiac reasons (9 (3.5%) vs 32 (8.4%); P = .003), re‐operation for bleeding (9 (3.5%) vs 27 (7.1%); P = .037) and major bleeding (14 (5.4%) vs 37 (9.8%); P = .033) were significantly higher in patients with a PVS>−4. The composite 30‐day early safety endpoint (234 (91.1%) vs 314 (82.8%); P = .002) confirms that an increased preoperative PVS is associated with a worse overall outcome after TAVI.
Conclusions
An elevated PVS (>−4) as a marker for congestion is associated with significantly worse outcome after TAVI and therefore should be incorporated in preprocedural risk stratification.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>32323303</pmid><doi>10.1111/eci.13251</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-4740-0197</orcidid><orcidid>https://orcid.org/0000-0003-4955-2714</orcidid><orcidid>https://orcid.org/0000-0002-7252-7130</orcidid><orcidid>https://orcid.org/0000-0003-4950-5432</orcidid><orcidid>https://orcid.org/0000-0002-3184-4914</orcidid><orcidid>https://orcid.org/0000-0001-7019-8575</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley |
| subjects | Aorta Aortic valve Bleeding cardiac decompensation Congestion Heart valves Hematocrit Implantation Mathematical analysis Original Paper Original Papers plasma volume Safety TAVR transcatheter aortic valve implantation Weight |
| title | The impact of subclinical congestion on the outcome of patients undergoing transcatheter aortic valve implantation |
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