Hatim Seoudy1,2, Mohammed Saad1, Mostafa Salem1, Kassem Allouch1, Johanne Frank1,2, Thomas Puehler2,3, Mohamed Salem2, Georg Lutter2,3, Christian Kuhn1, Derk Frank1,2. 1. Department of Internal Medicine III, Cardiology and Angiology, Campus Kiel, University Hospital Schleswig-Holstein, D-24105 Kiel, Germany. 2. DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, D-24105 Kiel, Germany. 3. Department of Cardiac and Vascular Surgery, Campus Kiel, University Hospital Schleswig-Holstein, D-24105 Kiel, Germany.
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.
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.
Authors: Ena Hasimbegovic; Marco Russo; Martin Andreas; Paul Werner; Iuliana Coti; Dominik Wiedemann; Alfred Kocher; Günther Laufer; Benedikt S Hofer; Markus Mach Journal: Front Cardiovasc Med Date: 2022-03-25