Key result
Elevated plasma volume status linked to ~53% higher 1-year mortality or HF hospitalization after TAVI.
Why the study?
Calculated plasma volume status reflects volume overload and relates to prognosis in heart failure, but its prognostic impact in patients undergoing TAVI required investigation.
Does elevated calculated plasma volume status predict all-cause mortality or heart failure hospitalization in patients undergoing TAVI?
Observational (n=859)
No
Does elevated calculated plasma volume status predict all-cause mortality or heart failure hospitalization in patients undergoing TAVI?
Hazard Ratio: 1.53 (95% CI 1.05–2.22)
Absolute Event Rate: 22.6% vs 13%
p-value: p=0.026
Elevated calculated plasma volume status is a significant independent predictor of 1-year mortality and heart failure hospitalization in patients undergoing TAVI, highlighting its potential utility for risk stratification and fluid management.
Background: Calculated plasma volume status (PVS) reflects volume overload based on the deviation of the estimated plasma volume (ePV) from the ideal plasma volume (iPV). Calculated PVS is associated with prognosis in the context of heart failure. This single-center study investigated the prognostic impact of PVS in patients undergoing transcatheter aortic valve implantation (TAVI). Methods: A total of 859 TAVI patients had been prospectively enrolled in an observational study and were included in the analysis. An optimal cutoff for PVS of −5.4% was determined by receiver operating characteristic curve analysis. The primary endpoint was a composite of all-cause mortality or heart failure hospitalization within 1 year after TAVI. Results: A total of 324 patients had a PVS < −5.4% (no congestion), while 535 patients showed a PVS ≥ −5.4% (congestion). The primary endpoint occurred more frequently in patients with a PVS ≥ −5.4% compared to patients with PVS < −5.4% (22.6% vs. 13.0%, p < 0.001). After multivariable adjustment, PVS was confirmed as a significant predictor of the primary endpoint (HR 1.53, 95% CI 1.05–2.22, p = 0.026). Conclusions: Elevated PVS, as a marker of subclinical congestion, is significantly associated with all-cause mortality and heart failure hospitalization within 1 year after TAVI.
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Seoudy et al. (2021) conducted an observational in Severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) (n=859). Calculated plasma volume status (PVS) ≥ −5.4% (congestion) vs. PVS < −5.4% (no congestion) was evaluated on Composite of all-cause mortality or heart failure hospitalization (HR 1.53, 95% CI 1.05-2.22, p=0.026). Elevated calculated plasma volume status (≥ −5.4%) was significantly associated with an increased risk of all-cause mortality or heart failure hospitalization at 1 year (HR 1.53).
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