道本 智
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Effect of Transcatheter Aortic Valve Implantation on Renal Function in Patients With Chronic Kidney Disease.
Journal Formal name:The American journal of cardiology
Abbreviation:Am J Cardiol
ISSN code:00029149/18791913
Domestic / ForeginForegin
Publisher Elsevier
Volume, Issue, Page 126,pp.82-88
Author and coauthor TAKADA Takuma†, JUJO Kentaro*, KONAMI Yutaka, OOTSUKI Hisao, TANAKA Kazuki, SAITO Chihiro, ISOMURA Shogo, DOMOTO Satoru, YAMAGUCHI Junichi, NIINAMI Hiroshi, HAGIWARA Nobuhjsa
Publication date 2020/07/01
Summary 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