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Hiltrop N, Belmans A, Claes M, et al. Functional performance and quality of life in high-risk comorbid patients undergoing transcatheter aortic valve implantation for symptomatic aortic valve stenosis. Eur Heart J Qual Care Clin Outcomes. 2016;2(3):184-192doi: 10.1093/ehjqcco/qcw001.
Hiltrop, N., Belmans, A., Claes, M., Hornikx, M., Peeters, B., Flamaing, J., Adriaenssens, T., De Praetere, H., Herregods, M. C., Herijgers, P., & Dubois, C. (2016). Functional performance and quality of life in high-risk comorbid patients undergoing transcatheter aortic valve implantation for symptomatic aortic valve stenosis. European heart journal. Quality of care & clinical outcomes, 2(3), 184-192. https://doi.org/10.1093/ehjqcco/qcw001
Hiltrop, Nick, et al. "Functional performance and quality of life in high-risk comorbid patients undergoing transcatheter aortic valve implantation for symptomatic aortic valve stenosis." European heart journal. Quality of care & clinical outcomes vol. 2,3 (2016): 184-192. doi: https://doi.org/10.1093/ehjqcco/qcw001
Hiltrop N, Belmans A, Claes M, Hornikx M, Peeters B, Flamaing J, Adriaenssens T, De Praetere H, Herregods MC, Herijgers P, Dubois C. Functional performance and quality of life in high-risk comorbid patients undergoing transcatheter aortic valve implantation for symptomatic aortic valve stenosis. Eur Heart J Qual Care Clin Outcomes. 2016 Jul 01;2(3):184-192. doi: 10.1093/ehjqcco/qcw001. PMID: 29474610.
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Eur Heart J Qual Care Clin Outcomes. 2016 Jul 01;2(3):184-192. doi: 10.1093/ehjqcco/qcw001.

Functional performance and quality of life in high-risk comorbid patients undergoing transcatheter aortic valve implantation for symptomatic aortic valve stenosis.

European heart journal. Quality of care & clinical outcomes

Nick Hiltrop, Ann Belmans, Marina Claes, Miek Hornikx, Bart Peeters, Johan Flamaing, Tom Adriaenssens, Herbert De Praetere, Marie-Christine Herregods, Paul Herijgers, Christophe Dubois

Affiliations

  1. Department of Cardiovascular Medicine, University Hospitals Leuven, Herestraat 49, Leuven, Belgium.
  2. Department of Public Health, Biostatistical Centre, Katholieke Universiteit Leuven, Leuven, Belgium.
  3. Department of Physical Medicine and Rehabilitation, Katholieke Universiteit Leuven, Leuven, Belgium.
  4. Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
  5. Department of Clinical and Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium.
  6. Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
  7. Department of Cardiovascular Surgery, University Hospitals Leuven, Leuven, Belgium.

PMID: 29474610 DOI: 10.1093/ehjqcco/qcw001

Abstract

AIMS: We assessed the impact of transcatheter aortic valve implantation (TAVI) on functional performance and quality of life (QoL) in a high-risk patient population with multiple comorbidities.

METHODS AND RESULTS: Between January 2009 and December 2014, 145 high-risk patients (EuroSCORE II 7.3% [4.9; 14.9]) with severe symptomatic aortic valve stenosis (AS) underwent TAVI in a single centre. We prospectively evaluated New York Heart Association (NYHA) functional class, 6-minute walking distance (6MWD), and QoL using the validated Dutch version of the EuroQol-5D (EQ-5D) descriptive assessment and a visual analogue scale (EQ-VAS) at baseline, 30 days, as well as 6, 12, and 24 months after TAVI. All patients were eligible for analysis. New York Heart Association functional class improved significantly at 30-day, 6-, 12-, and 24-month follow-up (P < 0.001 for all). The absolute 6MWD improved significantly at 30 days (+19.3 ± 8.2 m; P= 0.0499) and at 6 months (+23.3 ± 8.1 m; P = 0.0194). A favourable trend was maintained at 12 months (+17.1 ± 8.8 m; P = 0.1879), whereas at 24 months 6MWD was similar to baseline values. No significant change in the descriptive assessment of QoL (EQ5D) was observed, whereas the EQ-VAS showed a significant improvement in QoL up to 24 months (P < 0.0180 for all time-points).

CONCLUSION: In high-risk comorbid patients with symptomatic AS, TAVI results in a significant but temporary improvement of functional performance when assessed with objective measures of 6MWD but not of EQ-5D. Moreover, TAVI has a significant and sustained impact on subjective well-being and exercise capacity assessed with the EQ-VAS and NYHA score.

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