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Impact of perioperative change in physical function on midterm outcomes after transcatheter aortic valve implantation

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Abstract

Preoperative frailty diminishes the potential for functional recovery after transcatheter aortic valve implantation (TAVI). However, perioperative changes in physical status and their impact on prognosis after TAVI have not previously been reported. Therefore, this study aimed to investigate whether perioperative changes in physical function affect prognosis in patients undergoing TAVI. We retrospectively reviewed 257 patients who underwent TAVI. The Short Physical Performance Battery (SPPB), an objective physical status assessment tool, was evaluated pre- and post-TAVI. Patients were divided into two groups: (i) patients whose SPPB score declined in the perioperative period (the decline group) and (ii) patients whose SPPB score did not decline in the perioperative period (the non-decline group). The primary endpoint was unplanned hospitalization owing to heart failure or cardiovascular death following TAVI. The mean follow-up period was 385 ± 151 days, mean age was 83.2 ± 5.8 years, and 67% of the patients were women. Sixteen patients required readmission owing to heart failure, and seven experienced cardiovascular-related death. Kaplan–Meier analysis revealed that the event-free rate was significantly lower in the decline group (log-rank, p = 0.006). A stepwise multivariate logistic regression analysis showed that a perioperative change in SPPB was significantly associated with primary endpoints (odds ratio, 1.51; 95% confidence interval, 1.12–2.04). Perioperative change in physical function was an independent risk factor for heart failure, hospitalization, or cardiovascular death following TAVI.

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Acknowledgements

The authors would like to thank all members of the cardiology and rehabilitation center at the St. Marianna University School of Medicine.

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Kohei Ashikaga, Shunichi Doi, Kihei Yoneyama, Mika Watanabe, Norio Suzuki, Shingo Kuwata, Toshiki Kaihara, Masashi Koga, Kazuaki Okuyama, Ryo Kamijima, Yasuhiro Tanabe, Masaki Izumo & Yoshihiro J. Akashi

  2. Rehabilitation Center, St. Marianna University School of Medicine Hospital, Kawasaki, Japan

    Naoya Takeichi & Satoshi Watanabe

  3. Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan

    Keisuke Kida

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  1. Kohei Ashikaga
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Correspondence to Kohei Ashikaga.

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Ashikaga, K., Doi, S., Yoneyama, K. et al. Impact of perioperative change in physical function on midterm outcomes after transcatheter aortic valve implantation. Heart Vessels 36, 1072–1079 (2021). https://doi.org/10.1007/s00380-021-01776-4

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