Abstract 258: Prevalence and Clinical Correlates of LVH by Sokolow-lyon and Cornell ECG Voltage Criteria in TAVR Patients

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Robert Zhang ◽  
Emily Xiao ◽  
Tarek Ibrahim ◽  
Augustin Delago ◽  
Mohammad El-Hajjar ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Stenosis ◽  
Severe Aortic Stenosis ◽  
Retrospective Chart Review ◽  
Female Gender ◽  
Transfemoral Approach ◽  
Critical Aortic Stenosis ◽  
Ecg Criteria ◽  
Cornell Voltage

Background and Hypothesis: LV hypertrophy (LVH) due to critical aortic stenosis is expected in the TAVR patients. In a patient with a murmur and suspected aortic stenosis, absence of LVH by ECG criteria may suggest less severe aortic valve disease. However, the sensitivity of LVH analysis by ECG voltage criteria in patients with severe aortic valve stenosis undergoing trans-catheter aortic valve replacement (TAVR) has not yet been studied. Methods: A retrospective chart review was conducted in 388 consecutive TAVR patients (57.7% females, transfemoral approach in 59.3%, 77.9% with Sapien valve) without ventricular-paced rhythm. ECG data was collected and analyzed by Sokolow-Lyon and Cornell Voltage criteria. Results were compared to transthoracic echocardiogram. Analyses of variation, correlation, chi-square, and logistic regression were used. The study was approved by the institutional IRB. Results: LVH by echocardiographic criteria was present in all patients. Sokolow-Lyon and Cornell Voltage criteria for LVH were present and concordant in 15% of patients; and in 53% of patients, neither criteria was suggestive for LVH. Only 37% of patients had LVH by Cornell Voltage and 25% by Sokolow-Lyon criteria, indicative of poor concordance between these two commonly used ECG criteria for LVH (p<0.0001). Older age was strongly associated with presence of LVH voltage criteria by both Sokolow-Lyon (OR=1.052, 95%CI 1.019-1.085, p=0.001) and Cornell criteria (OR=1.030, 95%CI 1.002-1.059, p=0.035). However, female gender was only predictive of LVH voltage criteria by Sokolow-Lyon (OR=2.844, 95%CI 1.672-4.837, p=0.001) and not by Cornell criteria (OR=1.160, 95%CI 0.663-2.030, p=0.603). Conclusion: The presence of LVH by Sokolow-Lyon and Cornell ECG voltage criteria poorly correlates with the presence of LVH in critical aortic stenosis patients undergoing TAVR. Sokolow-Lyon may predict LVH better in female patients, Therefore, ECG does not appear to be a suitable method of screening patients with severe aortic stenosis for LVH and the lack of LVH by voltage criteria does not imply non-critical aortic valve stenosis.

Abstract 155: Prevalence and Clinical Correlates of Left Ventricular Hypertrophy by Sokolow-Lyon and Cornell Electrocardiogram Voltage Criteria in Transcatheter Aortic Valve Replacement Patients

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Emily Xiao ◽  
Augustin Delago ◽  
Mohammad El-Hajjar ◽  
Batyrjan Bulibek ◽  
Mikhail Torosoff
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Retrospective Chart Review ◽  
Left Ventricular ◽  
Aortic Valve Area ◽  
Chi Square ◽  
Cornell Voltage

Background and Hypothesis: The sensitivity of LVH analysis by ECG voltage criteria in patients with severe aortic valve stenosis undergoing trans-catheter aortic valve replacement (TAVR) has not yet been studied. LVH is expected in the TAVR population and would be reflected in voltage criteria by ECG. Methods: A retrospective chart review was conducted in 176 consecutive TAVR patients without ventricular-paced rhythm. ECG data was collected and analyzed by Sokolow-Lyon and Cornell Voltage criteria. Results were compared to transthoracic echocardiogram. Analyses of variation, correlation, chi-square, and logistic regression were used. The study was approved by the institutional IRB. Results: Sokolow-Lyon and Cornell Voltage criteria for LVH were present and concordant in 19% (33 of 176) of patients; in 49% (86 of 176) of patients, neither criteria was suggestive for LVH. Only 19% (34 of 176) of patients had LVH by Cornell Voltage and 13% (23 of 176) by Sokolow-Lyon criteria, indicative of poor concordance between these two commonly used ECG criteria for LVH (p<0.0001). Ejection fraction, aortic valve gradient, aortic valve area, COPD, PVD, prior stroke, dyslipidemia, and hypertension did not affect the prevalence of LVH by either or both criteria. Women (p<0.01) and patients with rhythm other than atrial fibrillation (p<0.0053) were more likely to have voltage criteria for LVH, while older adults were more likely to meet criteria for LVH. Concordant LVH criteria were noted in patients 84.6 +/- 7.2 years of age, while patients without LVH by ECG voltage criteria were significantly younger at 80.21 +/- 8.1 years of age (p<0.007). Conclusion: The presence of LVH by Sokolow-Lyon and Cornell ECG voltage criteria poorly correlates with the presence of LVH and critical aortic stenosis in TAVR patients. Women are more likely to have voltage criteria for LVH. Therefore, ECG may not be a suitable method of screening patients with severe aortic stenosis for LVH, especially in men.

Abstract 213: Prevalence and Regression of Left Ventricular Hypertrophy by Sokolow-lyon and Cornell Electrocardiogram Voltage Criteria After Transcatheter Aortic Valve Replacement

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Robert Zhang ◽  
Stephanie Jou ◽  
Angelo de la Rosa ◽  
Mohammad El-Hajjar ◽  
Anthony Nappi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Left Ventricular Hypertrophy ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Transfemoral Approach ◽  
Critical Aortic Stenosis ◽  
Ecg Criteria

Background and Hypothesis: Left Ventricular Hypertrophy (LVH) due to critical aortic stenosis is expected in TAVR patients. ECG markers of LVH were associated with a significant increase in all-cause mortality in a large prospective study (ARIC) of the general, middle-aged population. However, the sensitivity of LVH by ECG voltage criteria in patients with severe aortic valve stenosis undergoing trans-catheter aortic valve replacement (TAVR) has not yet been studied. The regression of LVH by ECG voltage criteria after TAVR also has not been evaluated. Methods: A retrospective chart review was conducted in 388 consecutive TAVR patients (57.7% females, transfemoral approach in 59.3%, 77.9% with Sapien valve) without ventricular-paced rhythm. ECG data was collected and analyzed by Sokolow-Lyon and Cornell Voltage criteria. Results were compared to transthoracic echocardiogram. Analyses of variation, correlation, chi-square, and logistic regression were used. The study was approved by the institutional IRB. Results: Pre-TAVR LVH by echocardiographic criteria was present in all patients. Sokolow-Lyon and Cornell criteria for LVH were present and concordant in 15% of patients; and in 53% of patients, neither ECG criteria was suggestive for LVH. Concordance between these two citeria was poor, with 37% of patients had LVH only by Cornell and 25% only by Sokolow-Lyon criteria (p<0.0001). One hundred forty one of 388 patients had follow up ECG’s at least 6 months (9.0+/-12.8 months) post-TAVR, with 13% no longer indicating LVH by Sokolow-Lyon criteria (p=0.005). Post-TAVR LVH by SL criteria was more likely in women (83 vs. 17%, p=0.015). Other co-morbidities and demographic variables were not predictive of LVH regression by ECG criteria. Conclusion: The presence of LVH by Sokolow-Lyon and Cornell ECG voltage criteria poorly correlates with the presence of LVH in critical aortic stenosis patients undergoing TAVR. Despite significant variability in pre-TAVR LVH manifestation by traditional ECG criteria, LVH regression by ECG criteria may be observed fairly soon after TAVR. Additional research is needed to clarify clinical implications and long-term outcomes associated with post-TAVR LVH regression.

scholarly journals Association between Comorbidities and Progression of Transvalvular Pressure Gradients in Patients with Moderate and Severe Aortic Valve Stenosis

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Tim Salinger ◽  
Kai Hu ◽  
Dan Liu ◽  
Scharoch Taleh ◽  
Sebastian Herrmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Stenosis ◽  
Severe Aortic Stenosis ◽  
Slow Progression ◽  
Fast Progression ◽  
Transvalvular Gradient

Background. Fast progression of the transaortic mean gradient (Pmean) is relevant for clinical decision making of valve replacement in patients with moderate and severe aortic stenosis (AS) patients. However, there is currently little knowledge regarding the determinants affecting progression of transvalvular gradient in AS patients. Methods. This monocentric retrospective study included consecutive patients presenting with at least two transthoracic echocardiography examinations covering a time interval of one year or more between April 2006 and February 2016 and diagnosed as moderate or severe aortic stenosis at the final echocardiographic examination. Laboratory parameters, medication, and prevalence of eight known cardiac comorbidities and risk factors (hypertension, diabetes, coronary heart disease, peripheral artery occlusive disease, cerebrovascular disease, renal dysfunction, body mass index ≥30 Kg/m2, and history of smoking) were analyzed. Patients were divided into slow (Pmean < 5 mmHg/year) or fast (Pmean ≥ 5 mmHg/year) progression groups. Results. A total of 402 patients (mean age 78 ± 9.4 years, 58% males) were included in the study. Mean follow-up duration was 3.4 ± 1.9 years. The average number of cardiac comorbidities and risk factors was 3.1 ± 1.6. Average number of cardiac comorbidities and risk factors was higher in patients in slow progression group than in fast progression group (3.3 ± 1.5 vs 2.9 ± 1.7; P=0.036). Patients in slow progression group had more often coronary heart disease (49.2% vs 33.6%; P=0.003) compared to patients in fast progression group. LDL-cholesterol values were lower in the slow progression group (100 ± 32.6 mg/dl vs 110.8 ± 36.6 mg/dl; P=0.005). Conclusion. These findings suggest that disease progression of aortic valve stenosis is faster in patients with fewer cardiac comorbidities and risk factors, especially if they do not have coronary heart disease. Further prospective studies are warranted to investigate the outcome of patients with slow versus fast progression of transvalvular gradient with regards to comorbidities and risk factors.

scholarly journals Sleep Quality in Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI)

2021 ◽  
Vol 18 (16) ◽  
pp. 8889
Author(s):  
Giulia Lorenzoni ◽  
Danila Azzolina ◽  
Chiara Fraccaro ◽  
Caterina Zoccarato ◽  
Clara Minto ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Sleep Quality ◽  
Transcatheter Aortic Valve Implantation ◽  
Severe Aortic Stenosis ◽  
P Value ◽  
Transfemoral Approach ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

The present study aimed to analyze sleep quality and quality of Life (QoL) in patients undergoing Transcatheter Aortic Valve Implantation (TAVI). It was conducted at the Interventional Cardiology Unit of the Department of Cardiac, Thoracic, Vascular Sciences and Public Health of the University of Padova on 27 adult patients who underwent TAVI via the transfemoral approach. Patients completed two validated instruments, i.e., the Pittsburgh Sleep Quality Index (PSQI) and the EuroQoL (EQ-5D-5L), on the day of discharge and one month after the hospital discharge. Twenty-seven patients were enrolled with a severe aortic stenosis diagnosis, treated with transfemoral TAVI procedure. The study population included seventeen poor sleepers and ten good sleepers with a median age of 81.92 years overall. The global PSQI evaluation revealed a small significant improvement at follow-up (p-value 0.007). Small positive changes were detected in the Self-care and Usual activity domains of the EQ-5D-5L and the EQ-VAS. No correlation was detected between EQ-5D-5L and sleep quality. The present study confirms the importance of sleep quality monitoring in patients who undergo TAVI procedure for aortic stenosis treatment.

scholarly journals A case report of an open aortic valve replacement followed by open adrenalectomy in a patient with symptomatic pheochromocytoma and critical aortic stenosis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Igor Feinstein ◽  
Tiffany Lee ◽  
Sameer Khan ◽  
Lindsay Raleigh ◽  
Frederick Mihm
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Medical Condition ◽  
Severe Aortic Stenosis ◽  
Vascular Supply ◽  
Adrenergic Blockade ◽  
Critical Aortic Stenosis ◽  
Highly Active

Abstract Background Pheochromocytoma is a rare medical condition caused by catecholamine-secreting tumor cells. Operative resection can be associated with significant hemodynamic fluctuations due to the nature of the tumor, as well as associated post-resection vasoplegia. To allow for cardiovascular recovery before surgery, patients require pre-operative alpha-adrenergic blockade, which would be limited in the setting of co-existent severe aortic stenosis. In this report, we describe a patient with severe aortic stenosis and symptomatic pheochromocytoma. Case presentation A 51-year-old man with severe aortic stenosis (valve area 0.8 cm2) was found to have a highly active 4 × 4 cm left adrenal pheochromocytoma. Alpha-adrenergic blockade for his pheochromocytoma was limited by syncope in the setting of his aortic stenosis. Open aortic valve replacement (AVR) was performed, followed by adrenalectomy the next day. The perioperative course for each surgical procedure was hemodynamically volatile, exacerbated by severe alcohol withdrawal. During the adrenalectomy, cardiogenic and vasoplegic shock developed immediately after securing the vascular supply to his tumor. This shock was refractory to vasopressin and methylene blue, but responded well to angiotensin II and epinephrine. After both surgeries were completed, his course was further complicated by severe ICU psychosis, ileus, fungal bacteremia, pneumonia/hypoxic respiratory failure and atrial fibrillation. He ultimately recovered and was discharged from the hospital after 38 days. Conclusion To our knowledge, this is the first report of surgical AVR and pheochromocytoma resection in a patient with critical aortic stenosis. The appropriate order and timing of surgeries when both these conditions co-exist remains controversial.

scholarly journals Open Aortic Valve Replacement Followed by Open Adrenalectomy In A Patient With Symptomatic Pheochromocytoma and Critical Aortic Stenosis: A Case Report

2020 ◽  
Author(s):  
Igor Feinstein ◽  
Tiffany Lee ◽  
Sameer Khan ◽  
Lindsay Raleigh ◽  
Fred Mihm
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Medical Condition ◽  
Severe Aortic Stenosis ◽  
Vascular Supply ◽  
Adrenergic Blockade ◽  
Critical Aortic Stenosis ◽  
Highly Active

Abstract Background: Pheochromocytoma is a rare medical condition caused by catecholamine-secreting tumor cells. Operative resection can be associated with significant hemodynamic fluctuations due to the nature of the tumor, as well as associated post-resection vasoplegia. To allow for cardiovascular recovery before surgery, patients require pre-operative alpha-adrenergic blockade, which would be limited in the setting of co-existent severe aortic stenosis. In this report, we describe a patient with severe aortic stenosis and symptomatic pheochromocytoma. Case presentation: A 51-year-old man with severe aortic stenosis (valve area 0.8 cm2) was found to have a highly active 4x4 cm left adrenal pheochromocytoma. Alpha-adrenergic blockade for his pheochromocytoma was limited by syncope in the setting of his aortic stenosis. Open aortic valve replacement (AVR) was performed, followed by adrenalectomy the next day. The perioperative course for each surgical procedure was hemodynamically volatile, exacerbated by severe alcohol withdrawal. During the adrenalectomy, cardiogenic and vasoplegic shock developed immediately after securing the vascular supply to his tumor. This shock was refractory to vasopressin and methylene blue, but responded well to angiotensin II and epinephrine. After both surgeries were completed, his course was further complicated by severe ICU psychosis, ileus, fungal bacteremia, pneumonia/hypoxic respiratory failure and atrial fibrillation. He ultimately recovered and was discharged from the hospital after 38 days. Conclusion: To our knowledge, this is the first report of surgical AVR and pheochromocytoma resection in a patient with critical aortic stenosis. The appropriate order and timing of surgeries when both these conditions co-exist remains controversial.

Clinical practice guideline for transcatheter versus surgical valve replacement in patients with severe aortic stenosis in Latin America

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319489
Author(s):  
Pablo Lamelas ◽  
Martin Alberto Ragusa ◽  
Rodrigo Bagur ◽  
Iqbal Jaffer ◽  
Henrique Ribeiro ◽  
...  
Keyword(s):  
Latin America ◽  
Cardiac Surgery ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Management Decision ◽  
Heart Team ◽  
Surgical Aortic Valve Replacement ◽  
Transfemoral Approach

In elderly (75 years or older) patients living in Latin America with severe symptomatic aortic stenosis candidates for transfemoral approach, the panel suggests the use of transcatheter aortic valve implant (TAVI) over surgical aortic valve replacement (SAVR). This is a conditional recommendation, based on moderate certainty in the evidence (⨁⨁⨁Ο).This recommendation does not apply to patients in which there is a standard of care, like TAVI for patients at very high risk for cardiac surgery or inoperable patients, or SAVR for non-elderly patients (eg, under 65 years old) at low risk for cardiac surgery. The suggested age threshold of 75 years old is based on judgement of limited available literature and should be used as a guide rather than a determinant threshold.The conditional nature of this recommendation means that the majority of patients in this situation would want a transfemoral TAVI over SAVR, but some may prefer SAVR. For clinicians, this means that they must be familiar with the evidence supporting this recommendation and help each patient to arrive at a management decision integrating a multidisciplinary team discussion (Heart Team), patient’s values and preferences through shared decision-making, and available resources. Policymakers will require substantial debate and the involvement of various stakeholders to implement this recommendation.

scholarly journals Are Outcomes of Surgical Versus Transcatheter Balloon Valvotomy Equivalent in Neonatal Critical Aortic Stenosis?

Circulation ◽  
2001 ◽  
Vol 104 (suppl_1) ◽  
Author(s):  
Brian W. McCrindle ◽  
Eugene H. Blackstone ◽  
William G. Williams ◽  
Rekwan Sittiwangkul ◽  
Thomas L. Spray ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Aortic Valve Stenosis ◽  
Balloon Dilation ◽  
Left Ventricular ◽  
Critical Aortic Stenosis ◽  
Significant Difference ◽  
Initial Procedure ◽  
Second Procedure

Background For neonates with critical aortic valve stenosis who are selected for biventricular repair, valvotomy can be achieved surgically (SAV) or by transcatheter balloon dilation (BAV). Methods and Results Data regarding 110 neonates with critical aortic valve stenosis were evaluated in a study by the Congenital Heart Surgeons Society from 1994 to 1999. Reduced left ventricular function was present in 46% of neonates. The initial procedure was SAV in 28 patients and BAV in 82 patients. Mean percent reduction in systolic gradient was significantly greater with BAV (65±17%) than SAV (41±32%; P <0.001). Higher residual median gradients were present in the SAV versus BAV group (36 mm Hg [range, 10 to 85 mm Hg] versus 20 mm Hg [0 to 85 mm Hg], P <0.001). Important aortic regurgitation was more often present after BAV (18%) than SAV (3%; P =0.07). Time-related survival after valvotomy was 82% at 1 month and 72% at 5 years, with no significant difference for SAV versus BAV, even after adjustment for differences in patient and disease characteristics. Independent risk factors for mortality were mechanical ventilation before valvotomy, smaller aortic valve annulus ( z score), smaller aortic diameter at the sinotubular junction ( z score), and a smaller subaortic region. A second procedure was performed in 46 survivors. Estimates for freedom from reintervention were 91% at 1 month and 48% at 5 years after the initial valvotomy and did not differ significantly between groups. Conclusions SAV and BAV for neonatal critical aortic stenosis have similar outcomes. There is a greater likelihood of important aortic regurgitation with BAV and of residual stenosis with SAV.

Aortic Valve Surgery

2019 ◽  
pp. 23-28
Author(s):  
Heather Reed ◽  
Stefan Lombaard ◽  
Samantha Arzillo
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Stenosis ◽  
Severe Aortic Stenosis ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Postoperative Assessment ◽  
Class 1 ◽  
History Of ◽  
Perioperative Transesophageal Echocardiography

Aortic valve stenosis is the most common primary valvular disease today. The natural history of aortic valve stenosis is most commonly described as a long latent period without symptoms as the disease progresses from mild to severe, followed by a shorter period with symptoms; ultimately, death will result if the stenosis is left untreated. Today, severe aortic stenosis is a class 1 indication for surgery. Classic symptoms include dyspnea, syncope, and angina. Diagnostic options include echocardiography, cardiac catheterization, computed tomography, and magnetic resonance imaging. Perioperative transesophageal echocardiography is necessary for preoperative and postoperative assessment of the patient who has severe aortic stenosis.

Abstract 19365: The Novel Biomarker Osteopontin Predicts Adverse Outcome in Patients Undergoing Treatment of Severe Aortic Stenosis by TAVI

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Matthias Lutz ◽  
Nora Ingersleben ◽  
Mark Rosenberg ◽  
Sandra Freitag-Wolf ◽  
Doreen Brehm ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Stenosis ◽  
Matrix Protein ◽  
Adverse Outcome ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Extracellular Matrix Protein ◽  
Data Set ◽  
Cox Regression Analysis

Background: Osteopontin (OPN) is an extracellular matrix protein that plays an integral role in myocardial remodeling and was previously shown as an important emerging biomarker in risk evaluation of cardiovascular disease. However, its prognostic value in patients with pressure overload of the left ventricular, caused by symptomatic severe aortic valve stenosis, undergoing transcatheter aortic valve implantation (TAVI) remains unclear. Methods: N=217 patients undergoing TAVI (using balloon-expandable Edwards Sapien XT prostheses) were included prospectively over a continuous period from Feb. 2011 until Dec. 2013. For all patients a complete clinical data set including biomarkers (OPN and NTproBNP), basic clinical assessment and echocardiography before and 7 days after TAVI was obtained. The primary endpoint was survival time. During median follow-up of 349d (Q1, Q3: 106-659.5d), a total of 66 deaths occurred, 30d mortality was 6.9%. Mean age was 81.8 years (± 6.03 y) and 55.8 % of the patients were female. Mean log. Euroscore was 25.4% (± 17.2%) and mean STS Score was 6.2% (± 3.8%). Results: Median preprocedurale OPN values were significantly elevated in patients with severe aortic valve stenosis compared to healthy controls (675 ng/ml, Q1,Q3: 488.5-990.5 ng/ml vs. 386 ng/ml, Q1, Q3: 324.5 - 458.0, p<0.001). Increased OPN levels before TAVI (upper quartile compared to lower three quartiles) revealed a HR of 2.151 (CI 1.31-3.531, p=0.002) for reduced survival. Multivariate Cox regression analysis including NTproBNP, postprocedural aortic regurgitation, atrial fibrillation, clinical risk scores and preprocedural left ventricular function (EF) demonstrates that OPN is even superior to NTproBNP and preprocedural EF in predicting adverse prognosis, showing a HR of 1.826 (CI 1.096-3.044, p=0.021). Conclusions: Elevated OPN levels predict adverse outcome in patients with severe aortic stenosis undergoing TAVI. OPN is superior to the established biomarker NTproBNP in risk stratification of patients undergoing TAVI.

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