Cited by 110Cardiac Valve Diseases and TreatmentsAortic Disease and Treatment ApproachesChronic Obstructive Pulmonary Disease (COPD) Research

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Chronic Obstructive Pulmonary Disease in Patients Undergoing Transcatheter Aortic Valve Implantation

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Mok, Michael, Nombela-Franco, Luis, Dumont, Eric, Urena, Marina, DeLarochellière, Robert, Doyle, Daniel, Villeneuve, Jacques, Côté, Mélanie, Ribeiro, Henrique B., Allende, Ricardo, Laflamme, Jerôme, DeLarochellière, Hugo, Laflamme, Louis, Amat-Santos, Ignacio, Pibarot, Philippe, Maltais, François, Rodés-Cabau, Josep·2013·JACC: Cardiovascular Interventions

DOI 10.1016/j.jcin.2013.06.008

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Abstract

Objectives This study sought to determine the effects of chronic obstructive pulmonary disease (COPD) on clinical outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) and to determine the factors associated with worse outcomes in COPD patients.Background No data exist on the factors determining poorer outcomes in COPD patients undergoing TAVI.Methods A total of 319 consecutive patients (29.5% with COPD) who underwent TAVI were studied. Functional status was evaluated by New York Heart Association (NYHA) functional class, Duke Activity Status Index, and the 6-min walk test (6MWT) at baseline and at 6 to 12 months. The TAVI treatment was considered futile if the patient either died or did not improve in NYHA functional class at 6-month follow-up.Results Survival rates at 1 year were 70.6% in COPD patients and 84.5% in patients without COPD (p = 0.008). COPD was an independent predictor of cumulative mortality after TAVI (hazard ratio: 1.84; 95% confidence interval: 1.08 to 3.13; p = 0.026). Improvement in functional status was observed after TAVI (p < 0.001 for NYHA functional class, Duke Activity Status Index, and 6MWT), but COPD patients exhibited less (p = 0.036) improvement in NYHA functional class. Among COPD patients, a shorter 6MWT distance predicted cumulative mortality (p = 0.013), whereas poorer baseline spirometry results (FEV1 [forced expiratory volume in the first second of expiration]) determined a higher rate of periprocedural pulmonary complications (p = 0.040). The TAVI treatment was futile in 40 COPD patients (42.5%) and a baseline 6MWT distance <170 m best determined the lack of benefit after TAVI (p = 0.002).Conclusions COPD was associated with a higher rate of mortality at mid-term follow-up. Among COPD patients, a higher degree of airway obstruction and a lower exercise capacity determined a higher risk of pulmonary complications and mortality, respectively. TAVI was futile in more than one-third of the COPD patients, and a shorter distance walked at the 6MWT predicted the lack of benefit after TAVI. These results may help to improve the clinical decision-making process in this challenging group of patients.

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Advantages of a prospective multidisciplinary approach in transcatheter aortic valve implantation: Eight years of experience
Costa, C., Teles, R. C., Brito, J., Neves, J. P., Gabriel, H. M., Abecassis, M., Ribeiras, R., Abecasis, J., Nolasco, T., Furstenau, M. D. C., et al. (2017) · Revista Portuguesa de Cardiologia (English Edition) · doi:10.1016/j.repce.2017.11.007

Authors: Mok, M., Nombela-Franco, L., Dumont, E., Urena, M., DeLarochellière, R., Doyle, D., Villeneuve, J., Côté, M., Ribeiro, H. B., Allende, R., Laflamme, J., DeLarochellière, H., Laflamme, L., Amat-Santos, I., Pibarot, P., Maltais, F., & Rodés-Cabau, J.
Affiliations: Institut universitaire de cardiologie et de pneumologie de Québec (CA)
ORCID: Mok, Michael
Doyle, Daniel
Ribeiro, Henrique B.
Allende, Ricardo
Amat-Santos, Ignacio
Maltais, François
Venue: JACC: Cardiovascular Interventions
Publisher: Elsevier BV
Published: 2013-10
Volume: 6
Issue: 10
Pages: 1072-1084
ISSN: 1876-7605 (ISSN-L)
1936-8798
DOI: 10.1016/j.jcin.2013.06.008
OpenAlex: W204202587
Cited by: 110
References: 34
Citations by year: 2026: 5 · 2025: 7 · 2024: 6 · 2023: 11 · 2022: 7 · 2021: 8 · 2020: 11 · 2019: 8 · 2018: 7 · 2017: 14 · 2016: 10 · 2015: 11 · 2014: 4
FWCI: 5.63
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 365 d)
Locations: JACC: Cardiovascular Interventions (publishedVersion)
PubMed (publishedVersion)
Corpus Université Laval (Université Laval) (submittedVersion)
Figshare (submittedVersion)
Funders: FundaciÃ³n Mutua MadrileÃ±a
Edwards Lifesciences
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Keywords: chronic obstructive pulmonary disease, transcatheter aortic valve implantation, mortality, functional status, 6-minute walk test, exercise capacity, pulmonary complications, procedural complications, spirometry, FEV1, NYHA functional class, futility of treatment, aortic stenosis, risk factors for poor outcome, airway obstruction, Duke Activity Status Index
MeSH terms: Aged, Aged, 80 and over, Aortic Valve Stenosis, Exercise Test, Female, Cardiac Catheterization, Humans, Lung, Male, Predictive Value of Tests, Risk Factors, Severity of Illness Index, Spirometry, Time Factors, Walking, Treatment Outcome, Exercise Tolerance, Patient Selection, Heart Valve Prosthesis Implantation, Recovery of Function, Pulmonary Disease, Chronic Obstructive, Kaplan-Meier Estimate

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Chronic Obstructive Pulmonary Disease in Patients Undergoing Transcatheter Aortic Valve Implantation

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