Abstract
Background: Calculated plasma volume status (PVS) reflects volume overload based on the deviation of the estimated plasma volume (ePV) from the ideal plasma volume (iPV). Calculated PVS is associated with prognosis in the context of heart failure. This single-center study investigated the prognostic impact of PVS in patients undergoing transcatheter aortic valve implantation (TAVI). Methods: A total of 859 TAVI patients had been prospectively enrolled in an observational study and were included in the analysis. An optimal cutoff for PVS of −5.4% was determined by receiver operating characteristic curve analysis. The primary endpoint was a composite of all-cause mortality or heart failure hospitalization within 1 year after TAVI. Results: A total of 324 patients had a PVS < −5.4% (no congestion), while 535 patients showed a PVS ≥ −5.4% (congestion). The primary endpoint occurred more frequently in patients with a PVS ≥ −5.4% compared to patients with PVS < −5.4% (22.6% vs. 13.0%, p < 0.001). After multivariable adjustment, PVS was confirmed as a significant predictor of the primary endpoint (HR 1.53, 95% CI 1.05–2.22, p = 0.026). Conclusions: Elevated PVS, as a marker of subclinical congestion, is significantly associated with all-cause mortality and heart failure hospitalization within 1 year after TAVI.
Highlights
Transcatheter aortic valve implantation (TAVI) has become an essential treatment option for severe aortic stenosis (AS) across the whole spectrum of surgical risk [1,2]
Diuretics were more frequently prescribed in patients with a plasma volume status (PVS) ≥ −5.4% compared to the PVS < −5.4% group (Table 1)
This study found that calculated PVS as a marker of hypervolemia was significantly associated with all-cause mortality and heart failure hospitalization in patients undergoing transcatheter aortic valve implantation (TAVI)
Summary
Transcatheter aortic valve implantation (TAVI) has become an essential treatment option for severe aortic stenosis (AS) across the whole spectrum of surgical risk [1,2]. In patients undergoing TAVI, subclinical congestion is associated with worse clinical outcomes. Plasma volume status (PVS) reflects the degree of deviation of the estimated plasma volume (ePV) from the ideal plasma volume (iPV) and has been shown to be associated with prognosis in patients with heart failure [8]. Calculated PVS is associated with prognosis in the context of heart failure This single-center study investigated the prognostic impact of PVS in patients undergoing transcatheter aortic valve implantation (TAVI). The primary endpoint was a composite of all-cause mortality or heart failure hospitalization within 1 year after TAVI. Conclusions: Elevated PVS, as a marker of subclinical congestion, is significantly associated with all-cause mortality and heart failure hospitalization within 1 year after TAVI
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