Aortic regurgitation index strongly associated with periAR

An aortic regurgitation index was strongly associated with periprosthetic aortic regurgitation after transcatheter aortic valve implantation, predicted 1-year mortality and provided prognostic information beyond the degree of aortic regurgitation, according to study data.

To evaluate the performance of the aortic regurgitation index ([diastolic BP – left ventricular end-diastolic pressure]/systolic BP) X 100) as a new hemodynamic parameter in an independent TAVR cohort and validate its application, 122 patients underwent TAVI by use of either the CoreValve (Medtronic; 79.5%) or the Sapien bioprosthesis (Edwards Lifesciences; 20.5%). A cutoff value of 25 identified patients at risk.

Researchers observed a stepwise decrease in aortic regurgitation index from 29.4 ± 6.3 in patients without periprosthetic aortic regurgitation (periAR; n=26) to 28 ± 8.5 with mild periAR (n=76), 19.6 ± 7.6 with moderate periAR (n=18), and 7.6 ± 2.6 with severe periAR (n=2; P<.001 for trend). One-year mortality rate among patients with aortic regurgitation index <25 was increased compared with patients with aortic regurgitation index ≥25 (42.3% vs. 14.3%; P<.001). In addition, the 1-year mortality risk in patients with none/mild periAR could be further stratified by an aortic regurgitation index <25 (31.3% vs. 14.3%; P=.04).

“We were able to demonstrate that the [aortic regurgitation] index as hemodynamic parameter is easy to quantify and allows an objective, fast and reproducible assessment of the degree of periAR directly during the procedure with the possibility to undertake effective measures to decrease periAR and therefore increase survival,” the researchers concluded.

For more information:

Vasa-Nicotera M. J Am Coll Cardiol Intv. 2012;5:858-865.