Introduction
Methods
Study population
Standard echocardiographic measurements
Clinical data and outcome
Statistical analysis
Results
Baseline clinical and echocardiographic characteristics
Total | LVEF > 50% | LVEF ≤ 50% | p value | |
---|---|---|---|---|
N = 618 | N = 462 | N = 156 | ||
Age (years) | 82 ± 6 (50–95) | 82 ± 5.4 | 81 ± 6.3 | 0.229 |
Male [n (%)] | 291 (47.1) | 193 (41.8) | 98 (62.8) | < 0.001 |
BMI (kg/m2) | 27.2 ± 4.8 | 27.3 ± 4.9 | 26.8 ± 4.5 | 0.234 |
NYHA class III–IV | 428 (69.3) | 319 (69.0) | 109 (69.9) | 0.920 |
EuroSCORE II (%) | 5.0 (3.2–9.0) | 5.9 ± 4.6 | 9.3 ± 6.1 | < 0.001 |
Comorbidities [n (%)] | ||||
Obesity | 145 (23.5) | 111 (24.0) | 34 (21.8) | 0.662 |
Hypertension | 509 (82.4) | 388 (84.0) | 121 (77.6) | 0.880 |
Diabetes mellitus | 216 (35.0) | 160 (34.6) | 56 (35.9) | 0.772 |
Dyslipidemia | 387 (62.6) | 281 (60.8) | 106 (67.9) | 0.126 |
Peripheral vascular disease | 74 (12.0) | 46 (10.0) | 28 (17.9) | 0.010 |
Chronic respiratory disease | 142 (23.0) | 103 (22.3) | 39 (25.0) | 0.510 |
Renal dysfunction (eGFR < 60ml/min/1.73m2) | 365 (59.1) | 270 (85.4) | 95 (60.9) | 0.638 |
History of myocardial infarction | 75 (12.1) | 38 (8.2) | 37 (23.7) | < 0.001 |
History of percutaneous coronary intervention | 185 (29.9) | 125 (27.1) | 60 (38.5) | 0.009 |
History of CABG | 71 (11.5) | 35 (7.6) | 36 (23.1) | < 0.001 |
History of atrial fibrillation | 261 (42.2) | 199 (43.1) | 62 (39.7) | 0.512 |
Malignancy | 128 (20.7) | 97 (21.0) | 31 (19.9) | 0.820 |
Complete LBBB | 49 (7.9) | 28 (6.1) | 21 (13.5) | 0.005 |
ICD or PM implantation | 82 (13.3) | 58 (12.6) | 24 (15.4) | 0.413 |
HF-related medications [n (%)] | ||||
ACEis | 298 (46.8) | 217 (47.1) | 81 (51.9) | 0.309 |
ARBs | 146 (23.6) | 120 (26.0) | 26 (16.7) | 0.017 |
Beta-blockers | 453 (73.3) | 338 (73.3) | 115 (73.7) | 0.999 |
Mineralocorticoid receptor antagonists | 98 (15.9) | 52 (11.3) | 46 (29.5) | < 0.001 |
Digitalis glycosides | 99 (16.0) | 69 (15.0) | 30 (19.2) | 0.209 |
Loop diuretics | 495 (80.1) | 353 (76.6) | 142 (91.0) | < 0.001 |
Laboratory data | ||||
Creatinine (mg/dl) [normal range 0–1.17] | 1.19 (0.94–1.50) | 1.15 (0.90–1.44) | 1.3 (1.0–1.6) | 0.002 |
eGFR (ml/min/1.73m2) [normal range > 90] | 55.0 (41–71) | 56.0 (41.0–71.0) | 53.0 (39.3–68.0) | 0.259 |
Urea (mg/dl) [normal range 10–50] | 47.7 (36.8–66.0) | 46.9 (35.2–64.5) | 51.4 (40.6–72.3) | 0.013 |
C-reactive protein (mg/dl) [normal range 0–0.5] | 0.40 (0.17–1.09) | 0.37 (0.14–0.96) | 0.59 (0.24–1.45) | < 0.001 |
Hemoglobin (g/dl) [normal range 14–18] | 12.3 (11.1–13.2) | 12.2 (10.9–13.1) | 12.6 (11.2–13.6) | 0.019 |
Albumin (g/dl) [normal range 3.5–5.5] | 4.2 (4.0–4.4) | 4.2 (4.0–4.4) | 4.2 (3.9–4.4) | 0.453 |
PTT (s) [normal range 23–36] | 31 (28–35) | 31 (28–35) | 32 (28–36) | 0.486 |
Thrombocyte (n*1000/µl) [normal range 150–450] | 220 (179–262) | 221 (182–263) | 216 (170–254) | 0.356 |
Alkaline phosphatase (U/l) [normal range 40–130] | 75.0 (61.0–94.0) | 74.0 (61.0–92.0) | 78.0 (63.0–100.0) | 0.083 |
NT-proBNP (pg/ml) | 2075 (862–6635) | 1357 (634.3–3545) | 6178 (1643–11,369) | < 0.001 |
hsTroponin (pg/ml) | 36.1 (26.3–59.8) | 36.2 (25.8–57.6) | 34.9 (24.9–112.9) | 0.802 |
TAVI approach | 0.252 | |||
Transfemoral | 385 (62.3) | 294 (63.6) | 91 (58.3) | |
Transapical | 233 (37.7) | 168 (36.4) | 65 (41.7) | |
Clinical outcomes | ||||
Follow-up duration (median and IQR) | 24 (12–42) | 24 (12–45) | 25 (13–36) | 0.462 |
All-cause death [n (%)] | 279 (45.1) | 206 (44.6) | 73 (46.8) | 0.643 |
30-day death [n (%)] | 32 (5.2) | 20 (4.3) | 12 (7.7) | 0.141 |
12-month death [n (%)] | 95 (15.4) | 68 (14.7) | 27 (17.3) | 0.443 |
24-month death [n (%)] | 140 (22.7) | 106 (22.9) | 34 (21.8) | 0.825 |
Cerebrovascular events [n (%)] | 26 (4.2) | 22 (4.8) | 4 (2.6) | 0.355 |
Acute kidney injury [n (%)] | 58 (9.4) | 41 (8.9) | 17 (10.9) | 0.432 |
Permanent pacemaker [n (%)] | 47 (7.6) | 34 (7.4) | 13 (8.3) | 0.727 |
New-onset LBBB [n (%)] | 36 (5.8) | 23 (5.0) | 13 (8.3) | 0.164 |
Total | LVEF > 50% | LVEF ≤ 50% | p value | |
---|---|---|---|---|
N = 618 | N = 462 | N = 156 | ||
A (cm) | 96 (71–119) | 98 (77–122) | 85 (53–109) | < 0.001 |
AVA Vmax (m/s) | 4.2 ± 0.7 | 4.3 ± 0.7 | 3.9 ± 0.7 | < 0.001 |
AVA PGmax (mmHg) | 74 (56–87) | 72 (58–90) | 64 (48–78) | < 0.001 |
AVA PGmean (mmHg) | 48 (36–57) | 47 (38–59) | 41 (31–50) | < 0.001 |
AV VTI (cm) | 102.5 ± 22.6 | 105.2 ± 22.3 | 93.5 ± 21.3 | < 0.001 |
AVA_Vmax (cm2) | 0.99 ± 4.1 | 1.1 ± 4.6 | 0.7 ± 0.2 | 0.390 |
AVA_VTI (cm2) | 0.78 ± 0.2 | 0.8 ± 0.2 | 0.7 ± 0.2 | 0.005 |
DT (ms) | 240 (159–305) | 224 (169–312) | 168 (133–254) | < 0.001 |
E (cm/s) | 99 (74–122) | 97 (74–124) | 95 (78–113) | 0.522 |
E/A | 1.2 (0.6–1.5) | 0.8 (0.6–1.3) | 1.1 (0.7–2) | 0.002 |
E/e′ lateral | 17 (11–20) | 15 (11–20) | 15 (12–21) | 0.193 |
E/e′ septal | 23 (16–28) | 21 (15–28) | 22 (17–30) | 0.069 |
e′ lateral (cm/s) | 6.5 ± 2.6 | 6.7 ± 2.6 | 6.1 ± 2.5 | 0.042 |
e′ septal (cm/s) | 4.8 ± 1.8 | 4.9 ± 1.8 | 4.4 ± 1.8 | 0.021 |
IVSd (mm) | 11.8 ± 2 | 11.9 ± 2.1 | 11.9 ± 2.0 | 0.045 |
LAA (cm2) | 24.5 ± 6.8 | 24.2 ± 6.8 | 25.6 ± 6.7 | 0.020 |
LAD (mm) | 42.3 ± 6.5 | 42.0 ± 6.4 | 43.3 ± 6.8 | 0.033 |
LAV (ml) | 81 (59–99) | 74 (57–96) | 81 (63–105) | 0.012 |
LAVi (ml/m2) | 45 (32–53) | 41 (32–52) | 44 (34–59) | 0.026 |
LVEDD (mm) | 47.5 ± 7.6 | 46.4 ± 7.2 | 51.3 ± 7.8 | < 0.001 |
LVEDV (ml) | 84 (59–101) | 72 (55–90) | 106 (81–132) | < 0.001 |
LVESD (mm) | 33.9 ± 8.5 | 32.2 ± 7.6 | 39.4 ± 8.7 | < 0.001 |
LVESV (ml) | 38 (21–48) | 26 (19–35) | 63 (45–81) | < 0.001 |
LVFS (%) | 29.4 ± 10.5 | 31.3 ± 10.3 | 23.3 ± 9.0 | < 0.001 |
LVMi (g/m2) | 115 (90–135) | 107 (88–133) | 122 (102–144) | < 0.001 |
LVOT (mm) | 21.9 ± 1.4 | 21.7 ± 1.3 | 22.5 ± 1.4 | < 0.001 |
LVOT CO (l/min) | 5.6 ± 1.8 | 5.8 ± 1.8 | 5.0 ± 1.5 | < 0.001 |
LVOT PGmax (mmHg) | 3 (2–4) | 3 (3–4) | 2 (2–3) | < 0.001 |
LVOT PGmean (mmHg) | 1.9 ± 0.8 | 2.0 ± 0.8 | 1.4 ± 0.6 | < 0.001 |
LVOT SV (ml) | 79 (65–91) | 81 (68–94) | 68 (55–78) | < 0.001 |
LVOT Vmax (m/s) | 0.84 ± 0.17 | 0.88 ± 0.2 | 0.73 ± 0.2 | < 0.001 |
LVOT VTI (cm) | 20.9 ± 5.1 | 22.1 ± 4.8 | 17.2 ± 4.3 | < 0.001 |
LVPWd (mm) | 11.4 ± 1.9 | 11.4 ± 1.9 | 11.1 ± 1.8 | 0.052 |
MAPSE lateral (mm) | 9.3 ± 2.3 | 9.6 ± 2.3 | 8.4 ± 2.3 | < 0.001 |
MAPSE septal (mm) | 7.9 ± 2.1 | 8.2 ± 2.1 | 7.1 ± 1.7 | < 0.001 |
RAA (cm2) | 18 (13–21) | 17 (13–21) | 17 (14–24) | 0.019 |
RVD basal (mm) | 36.8 ± 7 | 36.2 ± 6.7 | 38.7 ± 7.9 | 0.002 |
RVD mid (mm) | 27.7 ± 6.6 | 27.3 ± 6.2 | 29.0 ± 7.7 | 0.021 |
sPAP (mmHg) | 41 (32–49) | 39 (32–48) | 41 (32–50) | 0.533 |
TAPSE (mm) | 18.4 ± 4.9 | 18.9 ± 4.7 | 16.7 ± 4.9 | < 0.001 |
TR PGmax (mmHg) | 36 (27–42) | 34 (27–42) | 35 (27–44) | 0.540 |
TR Vmax (m/s) | 2.9 ± 0.6 | 2.9 ± 0.6 | 2.9 ± 0.6 | 0.996 |
Survival and left ventricular ejection fraction
Clinical risk factors associated with all-cause death overall mortality, 30-day mortality and 12-month mortality
Overall mortality | 30-day mortality | 12-month mortality | |||||||
---|---|---|---|---|---|---|---|---|---|
Unadjusted HR | 95% CI | p value | Unadjusted HR | 95% CI | p value | Unadjusted HR | 95% CI | p value | |
Age (years) | 1.000 | 0.973–1.028 | 0.993 | 1.021 | 0.940–1.109 | 0.620 | 0.992 | 0.950–1.036 | 0.707 |
Sex | 0.880 | 0.669–1.158 | 0.362 | 3.299 | 1.117–9.749 | 0.031 | 1.136 | 0.706–1.828 | 0.600 |
BMI (kg/m2) | 0.969 | 0.941–0.998 | 0.039 | 0.849 | 0.763–0.945 | 0.003 | 0.940 | 0.891–0.992 | 0.023 |
TAVI approach transapical versus transfemoral | 1.810 | 1.370–2.393 | < 0.001 | 2.035 | 0.879–4.710 | 0.097 | 1.933 | 1.214–3.080 | 0.006 |
CKD stage 3–5 | 1.434 | 1.084–1.898 | 0.012 | 1.897 | 0.742–4.849 | 0.181 | 1.521 | 0.925–2.500 | 0.098 |
NYHA III-IV | 1.073 | 0.801–1.437 | 0.636 | 0.787 | 0.330–1.875 | 0.588 | 1.135 | 0.677–1.904 | 0.631 |
Dyslipidemia | 1.335 | 1.018–1.750 | 0.037 | 1.572 | 0.682–3.626 | 0.289 | 1.484 | 0.932–2.365 | 0.096 |
Chronic respiratory disease | 1.151 | 0.840–1.576 | 0.383 | 1.049 | 0.387–2.843 | 0.925 | 0.957 | 0.542–1.693 | 0.881 |
Peripheral vascular disease | 1.334 | 0.896–1.986 | 0.155 | 1.404 | 0.415–4.743 | 0.585 | 1.690 | 0.888–3.214 | 0.110 |
Atrial fibrillation | 1.347 | 1.029–1.763 | 0.030 | 1.622 | 0.701–3.753 | 0.259 | 1.717 | 1.075–2.740 | 0.024 |
Hypertension | 1.108 | 0.757–1.622 | 0.597 | 0.840 | 0.284–2.482 | 0.753 | 1.162 | 0.596–2.269 | 0.659 |
Diabetes mellitus | 1.017 | 0.768–1.345 | 0.908 | 1.081 | 0.453–2.577 | 0.861 | 1.024 | 0.629–1.667 | 0.923 |
Myocardial infarction | 1.207 | 0.782–1.860 | 0.395 | 0.043 | 0.001–27.823 | 0.341 | 0.591 | 0.216–1.622 | 0.307 |
Creatinine (mg/dl) | 1.051 | 1.011–1.092 | 0.011 | 1.034 | 0.896–1.194 | 0.647 | 1.040 | 0.969–1.117 | 0.277 |
Urea (mg/dl) | 1.008 | 1.004–1.012 | < 0.001 | 1.000 | 0.986–1.013 | 0.968 | 1.006 | 0.999–1.012 | 0.081 |
C-reactive protein (mg/dl) | 1.225 | 1.096–1.369 | < 0.001 | 1.667 | 1.201–2.312 | 0.002 | 1.454 | 1.211–1.746 | < 0.001 |
Hemoglobin (g/dl) | 0.870 | 0.802–0.944 | < 0.001 | 0.788 | 0.617–1.006 | 0.056 | 0.802 | 0.700–0.919 | 0.001 |
LDL-Cholesterin (mg/dl) | 0.996 | 0.992–1.000 | 0.070 | 1.000 | 0.986–1.015 | 0.968 | 0.996 | 0.989–1.004 | 0.358 |
Use of amiodarone | 1.975 | 0.973–4.010 | 0.059 | 7.262 | 2.147–24.565 | 0.001 | 3.838 | 1.546–9.528 | 0.004 |
Use of antiplatelet drugs | 0.962 | 0.735–1.260 | 0.778 | 0.790 | 0.343–1.823 | 0.581 | 0.721 | 0.452–1.148 | 0.168 |
HF medications | |||||||||
Mineralcorticoid receptor antagonist | 1.173 | 0.777–1.769 | 0.447 | 0.041 | 0.001–13.489 | 0.281 | 1.162 | 0.577–2.337 | 0.674 |
Digitalis Glykosid | 1.054 | 0.742–1.499 | 0.768 | 0.907 | 0.268–3.065 | 0.875 | 1.048 | 0.551–1.993 | 0.887 |
Betablocker | 1.192 | 0.878–1.619 | 0.259 | 1.643 | 0.556–4.854 | 0.369 | 1.383 | 0.782–2.445 | 0.265 |
Loop diuretics | 1.406 | 0.993–1.990 | 0.055 | 1.372 | 0.464–4.056 | 0.567 | 1.351 | 0.740–2.466 | 0.327 |
ACE inhibitors | 0.939 | 0.716–1.230 | 0.646 | 1.136 | 0.493–2.620 | 0.765 | 1.189 | 0.747–1.894 | 0.465 |
ARBs | 0.834 | 0.606–1.148 | 0.266 | 0.441 | 0.131–1.492 | 0.188 | 0.667 | 0.372–1.197 | 0.175 |
Overall mortality | 30-day mortality | 12-month mortality | |||||||
---|---|---|---|---|---|---|---|---|---|
Unadjusted HR | 95% CI | p value | Unadjusted HR | 95% CI | p value | Unadjusted HR | 95% CI | p value | |
Age (years) | 0.996 | 0.959–1.035 | 0.848 | 1.027 | 0.925–1.142 | 0.614 | 0.986 | 0.929–1.046 | 0.629 |
Sex | 0.808 | 0.478–1.366 | 0.426 | 0.446 | 0.095–2.102 | 0.307 | 0.578 | 0.229–1.457 | 0.245 |
BMI (kg/m2) | 0.980 | 0.925–1.038 | 0.493 | 0.874 | 0.743–1.029 | 0.106 | 0.958 | 0.870–1.054 | 0.380 |
TAVI approach transapical versus transfemoral | 1.361 | 0.820–2.258 | 0.233 | 1.541 | 0.446–5.325 | 0.494 | 1.331 | 0.596–2.972 | 0.485 |
CKD stage 3–5 | 0.789 | 0.472–1.317 | 0.365 | 0.645 | 0.187–2.228 | 0.488 | 0.441 | 0.196–0.994 | 0.056 |
NYHA III-IV | 1.893 | 1.038–3.455 | 0.037 | 0.612 | 0.173–2.169 | 0.447 | 0.971 | 0.403–2.342 | 0.948 |
Dyslipidemia | 0.814 | 0.479–1.384 | 0.448 | 0.514 | 0.109–2.420 | 0.400 | 0.993 | 0.425–2.320 | 0.987 |
Chronic respiratory disease | 1.434 | 0.836–2.462 | 0.191 | 0.713 | 0.151–3.359 | 0.669 | 0.939 | 0.373–2.365 | 0.894 |
Peripheral vascular disease | 1.731 | 0.949–3.159 | 0.074 | 1.168 | 0.248–5.502 | 0.844 | 1.596 | 0.634–4.022 | 0.321 |
Atrial fibrillation | 1.172 | 0.704–1.950 | 0.542 | 0.989 | 0.279–3.505 | 0.986 | 1.536 | 0.690–3.420 | 0.293 |
Hypertension | 1.231 | 0.681–2.228 | 0.491 | 0.430 | 0.121–1.523 | 0.191 | 0.856 | 0.340–2.157 | 0.742 |
Diabetes mellitus | 1.377 | 0.813–2.331 | 0.234 | 1.198 | 0.338–4.245 | 0.780 | 0.745 | 0.309–1.796 | 0.511 |
Myocardial infarction | 1.267 | 0.715–2.244 | 0.418 | 1.442 | 0.373–5.577 | 0.596 | 1.172 | 0.465–2.954 | 0.736 |
Creatinine (mg/dl) | 1.188 | 0.914–1.545 | 0.198 | 1.407 | 0.992–1.996 | 0.056 | 1.064 | 0.692–1.634 | 0.778 |
Urea (mg/dl) | 1.009 | 1.000–1.018 | 0.056 | 1.016 | 0.997–1.036 | 0.102 | 0.995 | 0.978–1.012 | 0.552 |
C-reactive protein (mg/dl) | 1.513 | 1.210–1.893 | < 0.001 | 1.728 | 1.083–2.755 | 0.022 | 2.088 | 1.504–2.898 | < 0.001 |
Hemoglobin (g/dl) | 0.825 | 0.705–0.966 | 0.017 | 0.962 | 0.669–1.384 | 0.836 | 0.764 | 0.600–0.972 | 0.028 |
LDL-Cholesterin (mg/dl) | 1.001 | 0.994–1.007 | 0.856 | 1.002 | 0.985–1.019 | 0.831 | 0.997 | 0.986–1.009 | 0.661 |
Use of amiodarone | 1.201 | 0.369–3.905 | 0.761 | 2.758 | 0.349–21.781 | 0.336 | 2.396 | 0.563–10.198 | 0.237 |
Use of antiplatelet drugs | 0.578 | 0.347–0.963 | 0.035 | 0.285 | 0.074–1.103 | 0.069 | 0.308 | 0.132–0.720 | 0.007 |
HF medications | |||||||||
Mineralcorticoid receptor antagonist | 0.968 | 0.552–1.698 | 0.910 | 0.541 | 0.115–2.549 | 0.437 | 1.076 | 0.460–2.514 | 0.866 |
Digitalis Glykosides | 1.595 | 0.901–2.823 | 0.109 | 1.012 | 0.215–4.764 | 0.988 | 2.146 | 0.918–5.016 | 0.078 |
Betablocker | 1.801 | 0.635–1.840 | 0.774 | 0.547 | 0.154–1.939 | 0.350 | 0.731 | 0.313–1.709 | 0.470 |
Loop diuretics | 3.062 | 0.951–9.856 | 0.061 | 0.901 | 0.114–7.111 | 0.921 | 2.238 | 0.302–16.579 | 0.430 |
ACE inhibitors | 0.856 | 0.520–1.408 | 0.539 | 0.866 | 0.251–2.990 | 0.819 | 0.603 | 0.268–1.358 | 0.222 |
ARBs | 0.917 | 0.452–1.862 | 0.811 | 0.038 | 0.001–55.36 | 0.379 | 0.465 | 0.109–1.976 | 0.299 |
Overall mortality | 30-day mortality | 12-month mortality | |||||||
---|---|---|---|---|---|---|---|---|---|
Clinical covariates adjusted HR | 95% CI | p value | Clinical covariates adjusted HR | 95% CI | p value | Clinical covariates adjusted HR | 95% CI | p value | |
LVEF > 50% | |||||||||
Sex | – | – | – | 3.521 | 1.189–10.424 | 0.023 | – | – | – |
BMI (kg/m2) | 0.958 | 0.929–0.988 | 0.006 | 0.853 | 0.772–0.941 | 0.002 | 0.936 | 0.889–0.986 | 0.013 |
TAVI approach transapical versus transfemoral | 1.710 | 1.280–2.286 | < 0.001 | – | – | – | 1.687 | 1.043–2.731 | 0.033 |
CKD stage 3–5 | 1.189 | 0.849–1.665 | 0.314 | – | – | – | – | – | – |
Dyslipidemia | 1.335 | 1.017–1.754 | 0.037 | – | – | – | – | – | – |
Atrial fibrillation | 1.167 | 0.887–1.536 | 0.271 | – | – | – | 1.345 | 0.827–2.187 | 0.232 |
Creatinine (mg/dl) | 1.042 | 0.983–1.105 | 0.165 | – | – | – | – | – | – |
Urea (mg/dl) | 1.004 | 0.998–1.009 | 0.167 | – | – | – | – | – | – |
C-reactive protein (mg/dl) | 1.139 | 1.014–1.279 | 0.028 | 1.819 | 1.317–2.512 | < 0.001 | 1.365 | 1.125–1.657 | 0.002 |
Hemoglobin (g/dl) | 0.914 | 0.832–1.003 | 0.057 | – | – | – | 0.868 | 0.750–1.004 | 0.057 |
Use of amiodarone | – | – | – | 10.532 | 2.895–38.316 | < 0.001 | 3.266 | 1.132–9.424 | 0.029 |
LVEF ≤ 50% | |||||||||
NYHA III-IV | 2.429 | 1.277–4.620 | 0.007 | – | – | – | – | – | – |
C-reactive protein (mg/dl) | 1.497 | 1.184–1.894 | < 0.001 | – | – | – | 1.950 | 1.359–2.797 | < 0.001 |
Hemoglobin (g/dl) | 0.848 | 0.729–0.987 | 0.033 | – | – | – | 0.883 | 0.684–1.140 | 0.341 |
Use of antiplatelet drugs | 0.610 | 0.358–1.040 | 0.069 | – | – | – | 0.354 | 0.149–0.842 | 0.019 |
Independent echocardiographic predictors for TAVI patients with preserved or reduced LVEF
Overall mortality | 30-day mortality | 12-month mortality | |||||||
---|---|---|---|---|---|---|---|---|---|
Univariate HR | 95% CI | p value | Univariate HR | 95% CI | p value | Univariate HR | 95% CI | p value | |
LVEF > 50% | |||||||||
Cardiac Sizes | |||||||||
IVSd (mm) | 1.020 | 0.954–1.090 | 0.567 | 1.244 | 1.059–1.461 | 0.008 | 1.065 | 0.954–1.190 | 0.263 |
LAA (cm2) | 1.028 | 1.008–1.048 | 0.005 | 1.054 | 1.001–1.109 | 0.046 | 1.028 | 0.996–1.061 | 0.091 |
LAD (mm) | 1.031 | 1.009–1.053 | 0.006 | 1.063 | 0.994–1.137 | 0.076 | 1.047 | 1.009–1.086 | 0.014 |
LVEDD (mm) | 0.999 | 0.980–1.018 | 0.900 | 0.951 | 0.896–1.009 | 0.095 | 0.975 | 0.944–1.007 | 0.128 |
LVMi (g/m2) | 1.002 | 0.998–1.005 | 0.399 | 1.004 | 0.993–1.016 | 0.452 | 0.999 | 0.993–1.006 | 0.859 |
LVPWd (mm) | 1.026 | 0.956–1.100 | 0.478 | 1.235 | 1.028–1.483 | 0.024 | 1.047 | 0.928–1.181 | 0.457 |
RAA (cm2) | 1.024 | 1.005–1.044 | 0.014 | 1.032 | 0.976–1.090 | 0.271 | 1.029 | 0.997–1.062 | 0.077 |
RVD_basal (mm) | 1.021 | 0.999–1.044 | 0.061 | 1.010 | 0.943–1.082 | 0.772 | 1.008 | 0.971–1.046 | 0.677 |
RVD_mid (mm) | 1.017 | 0.993–1.041 | 0.177 | 1.005 | 0.933–1.082 | 0.905 | 1.004 | 0.965–1.044 | 0.844 |
LVEF (%) | 0.991 | 0.973–1.010 | 0.352 | 0.990 | 0.937–1.046 | 0.728 | 0.978 | 0.948–1.009 | 0.165 |
Systolic function | |||||||||
MAPSE lateral (mm) | 0.918 | 0.864–0.975 | 0.006 | 0.862 | 0.695–1.070 | 0.177 | 0.917 | 0.821–1.025 | 0.126 |
MAPSE septal (mm) | 0.883 | 0.823–0.947 | < 0.001 | 0.708 | 0.545–0.921 | 0.010 | 0.836 | 0.739–0.947 | 0.005 |
TAPSE (mm) | 0.949 | 0.920–0.979 | < 0.001 | 0.888 | 0.801–0.985 | 0.025 | 0.928 | 0.880–0.978 | 0.006 |
DD | |||||||||
Moderate to severe versus mild | 1.445 | 1.089–1.919 | 0.011 | 3.179 | 1.076–9.394 | 0.036 | 1.861 | 1.110–3.121 | 0.019 |
Lateral E/E′ | 1.003 | 0.986–1.020 | 0.770 | 1.028 | 0.985–1.072 | 0.205 | 0.999 | 0.970–1.029 | 0.957 |
Septal E/E′ | 1.017 | 1.003–1.031 | 0.015 | 1.062 | 1.026–1.098 | < 0.001 | 1.028 | 1.006–1.051 | 0.013 |
sPAP (mmHg) | 1.020 | 1.011–1.030 | < 0.001 | 1.042 | 1.016–1.068 | 0.001 | 1.025 | 1.008–1.041 | 0.003 |
LVEF≤50% | |||||||||
Cardiac Sizes | |||||||||
IVSd (mm) | 1.059 | 0.934–1.200 | 0.372 | 0.845 | 0.617–1.158 | 0.295 | 0.948 | 0.776–1.158 | 0.602 |
LAA (cm2) | 1.022 | 0.984–1.062 | 0.266 | 1.027 | 0.932–1.133 | 0.586 | 1.057 | 0.994–1.124 | 0.076 |
LAD (mm) | 1.032 | 0.995–1.070 | 0.093 | 1.011 | 0.924–1.107 | 0.806 | 1.060 | 1.001–1.123 | 0.045 |
LVEDD (mm) | 0.980 | 0.953–1.009 | 0.173 | 1.014 | 0.936–1.098 | 0.741 | 1.000 | 0.951–1.052 | 0.999 |
LVMi (g/m2) | 0.997 | 0.990–1.005 | 0.507 | 0.994 | 0.975–1.013 | 0.540 | 1.001 | 0.989–1.014 | 0.827 |
LVPWd (mm) | 1.103 | 0.948–1.282 | 0.204 | 0.849 | 0.595–1.212 | 0.368 | 1.120 | 0.897–1.399 | 0.317 |
RAA (cm2) | 1.035 | 0.994–1.079 | 0.099 | 1.051 | 0.953–1.160 | 0.318 | 1.060 | 0.998–1.126 | 0.060 |
RVD_basal (mm) | 0.993 | 0.958–1.029 | 0.701 | 0.939 | 0.845–1.042 | 0.236 | 0.968 | 0.913–1.026 | 0.269 |
RVD_mid (mm) | 0.994 | 0.959–1.031 | 0.749 | 0.927 | 0.828–1.036 | 0.182 | 0.956 | 0.897–1.018 | 0.159 |
LVEF (%) | 1.001 | 0.966–1.037 | 0.954 | 0.978 | 0.913–1.048 | 0.533 | 1.027 | 0.971–1.086 | 0.354 |
Systolic function | |||||||||
MAPSE lateral (mm) | 1.001 | 0.898–1.115 | 0.989 | 1.005 | 0.755–1.338 | 0.971 | 1.053 | 0.890–1.246 | 0.545 |
MAPSE septal (mm) | 0.849 | 0.723–0.997 | 0.047 | 1.162 | 0.813–1.662 | 0.410 | 0.939 | 0.736–1.198 | 0.613 |
TAPSE (mm) | 0.951 | 0.899–1.006 | 0.079 | 0.953 | 0.820–1.107 | 0.526 | 0.957 | 0.875–1.048 | 0.343 |
DD | |||||||||
Moderate to severe versus mild | 1.130 | 0.653–1.955 | 0.663 | 1.550 | 0.329–7.300 | 0.579 | 1.190 | 0.472–2.998 | 0.712 |
Lateral E/E′ | 0.988 | 0.961–1.015 | 0.379 | 1.030 | 0.978–1.085 | 0.263 | 0.986 | 0.938–1.037 | 0.580 |
Septal E/E′ | 1.009 | 0.988–1.030 | 0.409 | 1.031 | 0.974–1.091 | 0.290 | 1.012 | 0.973–1.051 | 0.554 |
sPAP (mmHg) | 1.001 | 0.983–1.019 | 0.946 | 1.006 | 0.958–1.057 | 0.801 | 1.010 | 0.980–1.040 | 0.521 |
Multivariable model including echocardiographic covariates | Final model including echocardiographic and clinical covariates | |||
---|---|---|---|---|
Overall mortality: echocardiographic predictors for patients with LVEF > 50% | ||||
HR (95% CI) | p value | HR (95% CI) | p value | |
LAA (cm2) | 1.013 (0.983–1.045) | 0.393 | ||
RAA (cm2) | 0.992 (0.962–1.024) | 0.627 | ||
MAPSE septal (mm) | 0.944 (0.862–1.033) | 0.206 | ||
TAPSE (mm) | 0.958 (0.922–0.996) | 0.031 | 0.951 (0.921–0.982) | 0.002 |
≤ 17 versus > 17 mm | 1.528 (1.083–2.154) | 0.016 | ||
DD moderate to severe versus mild | 0.813 (0.539–1.226) | 0.323 | ||
E/E′ septal | 1.011 (0.995–1.027) | 0.176 | ||
sPAP (mmHg) | 1.015 (1.003–1.028) | 0.014 | 1.015 (1.004–1.025) | 0.007 |
> 30 versus ≤ 30 mmHg | 1.900 (1.253–2.880) | 0.002 |
Overall mortality: Echocardiographic predictors for patients with LVEF ≤ 50% | ||||
---|---|---|---|---|
HR (95% CI) | p value | HR (95% CI) | p value | |
MAPSE septal (mm) | 0.883 (0.751–1.037) | 0.129 |
30-day mortality: echocardiographic predictors for patients with LVEF > 50% | ||||
---|---|---|---|---|
HR (95% CI) | p value | HR (95% CI) | p value | |
IVSd (mm) | 1.085 (0.866–1.360) | 0.478 | ||
LAA (cm2) | 1.036 (0.954–1.126) | 0.398 | ||
MAPSE septal (mm) | 0.933 (0.672–1.295) | 0.679 | ||
TAPSE (mm) | 0.924 (0.809–1.055) | 0.244 | ||
DD moderate to severe versus mild | 0.773 (0.167–3.578) | 0.742 | ||
E/E′ septal | 1.048 (1.003–1.095) | 0.035 | 1.072 (1.031–1.114) | < 0.001 |
> 21 versus ≤ 21 | 14.462 (1.892–110.550) | 0.010 | ||
sPAP (mmHg) | 1.019 (0.979–1.061) | 0.354 |
30-day mortality: echocardiographic predictors for patients with LVEF ≤ 50% | ||||
---|---|---|---|---|
HR (95% CI) | p value | HR (95% CI) | p value | |
– | – | – | – | – |
12-month mortality: Echocardiographic predictors for patients with LVEF > 50% | ||||
---|---|---|---|---|
HR (95% CI) | p value | HR (95% CI) | p value | |
LAD (mm) | 1.030 (0.982–1.080) | 0.230 | ||
MAPSE septal (mm) | 0.942 (0.808–1.099) | 0.450 | ||
TAPSE (mm) | 0.966 (0.906–1.031) | 0.301 | ||
DD moderate to severe versus mild | 0.993 (0.499–1.971) | 0.983 | ||
E/E′ septal | 1.027 (1.002–1.052) | 0.036 | 1.027 (1.004–1.050) | 0.019 |
> 21 versus ≤ 21 | 1.881 (1.079–3.278) | 0.026 | ||
sPAP (mmHg) | 1.002 (0.981–1.024) | 0.853 |
12-month mortality: Echocardiographic predictors for patients with LVEF ≤ 50% | ||||
---|---|---|---|---|
HR (95% CI) | p value | HR (95% CI) | p value | |
LAD (mm) | 1.011 (0.951–1.074) | 0.726 |