Objective To evaluate immediate transcatheter aortic valve implantation （TAVI） results and medium-term follow-up in very elderly pa- tients with severe and symptomatic aortic stenosis （AS）. Methods This multicente...Objective To evaluate immediate transcatheter aortic valve implantation （TAVI） results and medium-term follow-up in very elderly pa- tients with severe and symptomatic aortic stenosis （AS）. Methods This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly （〉 85 years） patients with severe AS treated by TAVI. The primary endpoint was to evaluate death rotes from any cause at two years. Results The study included 160 consecutive patients with a mean age of 87 ± 2.1 years （range from 85 to 94 years） and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 （35.6%） patients scoring 〉 20%. Procedural success rate was 97.5%, with 25 （15.6%） patients experiencing acute complications with major bleeding （the most frequent）. Global mortality rate during hospitalization was 8.8% （n = 14） and 30-day mortality rate was 10% （n = 16）. Median follow up period was 252.24± 232.17 days. During the follow-up period, 28 （17.5%） patients died （17 of them due to cardiac causes）. The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique vari- able associated with overall mortality. Conclusions TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients.展开更多
Given the increase in life expectancy indeveloped countries,nonagenarian population will become clinically and numerically relevant in our daily routine practice in the near future.Age has been observed to exert a pro...Given the increase in life expectancy indeveloped countries,nonagenarian population will become clinically and numerically relevant in our daily routine practice in the near future.Age has been observed to exert a profound influence on the prevalence of severe mitral regurgitation (MR) in the population.[1]Mitral valve surgery remains the gold standard of care for patients with symptomatic severe MR.展开更多
AIM: To study whether the concentrations of particulate matter in ambient air are associated with hospitaladmission due to heart failure in patients with heart failure with preserved ejection fraction and reduced ejec...AIM: To study whether the concentrations of particulate matter in ambient air are associated with hospitaladmission due to heart failure in patients with heart failure with preserved ejection fraction and reduced ejection fraction. METHODS: We studied 353 consecutive patients admitted into a tertiary care hospital with a diagnosis of heart failure. Patients with ejection fraction of ≥ 45% were classified as having heart failure with preserved ejection fraction and those with an ejection fraction of < 45% were classified as having heart failure with reduced ejection fraction. We determined the average concentrations of different sizes of particulate matter (< 10, < 2.5, and < 1 μm) and the concentrations of gaseous pollutants (carbon monoxide, sulphur dioxide, nitrogen dioxide and ozone) from 1 d up to 7 d prior to admission. RESULTS: The heart failure with preserved ejection fraction population was exposed to higher nitrogen dioxide concentrations compared to the heart failure with reduced ejection fraction population (12.95 ± 8.22 μg/m 3 vs 4.50 ± 2.34 μg/m 3 , P < 0.0001). Multivariate analysis showed that nitrogen dioxide was a significant predictor of heart failure with preserved ejection fraction (odds ratio ranging from (1.403, 95%CI: 1.003-2.007, P = 0.04) to (1.669, 95%CI: 1.043-2.671, P = 0.03). CONCLUSION: This study demonstrates that shortterm nitrogen dioxide exposure is independently associated with admission in the heart failure with preserved ejection fraction population.展开更多
文摘Objective To evaluate immediate transcatheter aortic valve implantation （TAVI） results and medium-term follow-up in very elderly pa- tients with severe and symptomatic aortic stenosis （AS）. Methods This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly （〉 85 years） patients with severe AS treated by TAVI. The primary endpoint was to evaluate death rotes from any cause at two years. Results The study included 160 consecutive patients with a mean age of 87 ± 2.1 years （range from 85 to 94 years） and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 （35.6%） patients scoring 〉 20%. Procedural success rate was 97.5%, with 25 （15.6%） patients experiencing acute complications with major bleeding （the most frequent）. Global mortality rate during hospitalization was 8.8% （n = 14） and 30-day mortality rate was 10% （n = 16）. Median follow up period was 252.24± 232.17 days. During the follow-up period, 28 （17.5%） patients died （17 of them due to cardiac causes）. The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique vari- able associated with overall mortality. Conclusions TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients.
文摘Given the increase in life expectancy indeveloped countries,nonagenarian population will become clinically and numerically relevant in our daily routine practice in the near future.Age has been observed to exert a profound influence on the prevalence of severe mitral regurgitation (MR) in the population.[1]Mitral valve surgery remains the gold standard of care for patients with symptomatic severe MR.
基金Supported by The framework of one research projects funded by the Spanish Society of Cardiology (Daiichi-Sankyo project 2011)
文摘AIM: To study whether the concentrations of particulate matter in ambient air are associated with hospitaladmission due to heart failure in patients with heart failure with preserved ejection fraction and reduced ejection fraction. METHODS: We studied 353 consecutive patients admitted into a tertiary care hospital with a diagnosis of heart failure. Patients with ejection fraction of ≥ 45% were classified as having heart failure with preserved ejection fraction and those with an ejection fraction of < 45% were classified as having heart failure with reduced ejection fraction. We determined the average concentrations of different sizes of particulate matter (< 10, < 2.5, and < 1 μm) and the concentrations of gaseous pollutants (carbon monoxide, sulphur dioxide, nitrogen dioxide and ozone) from 1 d up to 7 d prior to admission. RESULTS: The heart failure with preserved ejection fraction population was exposed to higher nitrogen dioxide concentrations compared to the heart failure with reduced ejection fraction population (12.95 ± 8.22 μg/m 3 vs 4.50 ± 2.34 μg/m 3 , P < 0.0001). Multivariate analysis showed that nitrogen dioxide was a significant predictor of heart failure with preserved ejection fraction (odds ratio ranging from (1.403, 95%CI: 1.003-2.007, P = 0.04) to (1.669, 95%CI: 1.043-2.671, P = 0.03). CONCLUSION: This study demonstrates that shortterm nitrogen dioxide exposure is independently associated with admission in the heart failure with preserved ejection fraction population.
