コヤナギ　チヒロ   Koyanagi Chihiro   小栁　千紘    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Effect of Transcatheter Aortic Valve Implantation on Renal Function in Patients With Chronic Kidney Disease.
掲載誌名	正式名：The American journal of cardiology 略　 称：Am J Cardiol ISSNコード：00029149/18791913
掲載区分	国外
出版社	Elsevier
巻・号・頁	126,pp.82-88
著者・共著者	TAKADA Takuma†, JUJO Kentaro*, KONAMI Yutaka, OOTSUKI Hisao, TANAKA Kazuki, SAITO Chihiro, ISOMURA Shogo, DOMOTO Satoru, YAMAGUCHI Junichi, NIINAMI Hiroshi, HAGIWARA Nobuhjsa
発行年月	2020/07/01
概要	Transcatheter aortic valve implantation (TAVI) theoretically increases cardiac output and renal blood flow, and renal function (RF) recovers in patients with severe aortic valve stenosis (AS). However, procedural steps of TAVI including contrast use potentially damage RF. Data describing RF improvements after TAVI in patients with chronic kidney disease (CKD) are lacking. We aimed to determine preoperative predictors of RF improvement after TAVI in severe AS patients with CKD. This observational study included 121 consecutive patients with severe AS and CKD (grade ≥3) who underwent TAVI. The patients were grouped according to their RF improvement after TAVI that was defined as an estimated glomerular filtration rate (eGFR) increase ≥10% at discharge from their preoperative level. Sixty-five patients' (54%) RF improved after TAVI. Patients with lower preoperative eGFR tended to achieve greater eGFR increases after TAVI (r = -0.17, p = 0.059). After adjustments for the factors that were significant in the univariate analysis, the preoperative mean transaortic pressure gradient (TAPG) (adjusted odds ratio, 1.03; 95% confidence interval, 1.00 to 1.07) and E/e' (adjusted odds ratio, 0.93; 95% confidence interval, 0.88 to 0.99) independently predicted RF improvement. The cut-off values for the preoperative mean TAPG and E/e' for an RF improvement after TAVI were 47.0 mm Hg and 13.8, respectively. In conclusion, preoperatively, a high mean TAPG and a low E/e' could predict RF improvement after TAVI in patients with CKD.
DOI	10.1016/j.amjcard.2020.04.001
PMID	32327190