TAVI improves quality of life in patients with severe aortic stenosis for at least 1 year
Transcatheter aortic valve implantation (TAVI) leads to meaningful improvements in health-related quality of life in patients with severe aortic stenosis that are maintained for at least 1 year, according to a study presented at ESC Congress 2012. The results from the German transcatheter aortic valve interventions registry were presented by Professor Till Neumann, MD, from Essen, Germany.
Aortic stenosis is the most common valvular heart disease with increasing incidence especially with regard to the ageing of the population. Today, the prevalence of aortic stenosis is estimated at about 2.5% of 75 year olds and 8.1% of people aged 85 years.
TAVI, introduced in 2002 by Dr Alain Cribier from France and 2005 by Dr John Webb from Canada, has been shown to improve survival compared with standard therapy in patients with severe aortic stenosis who cannot have surgery. In particular, older patients with aortic stenosis cannot always be offered conventional surgical aortic valve replacement at an acceptable risk. As a consequence, about 30% of these patients are presently not operated. Therefore TAVI is currently an alternative treatment option.
The prospective multicentre German transcatheter aortic valve interventions registry includes patients with symptomatic, severe aortic stenosis since January 2009. "The registry was designed to monitor current use and outcome of transcatheter aortic valve interventions, including TAVI, in daily clinical routine, and to evaluate safety, effectiveness and health economic data," said Professor Neumann. "Therefore, the registry gives insight into a real world setting of using the TAVI procedure."
Health-related quality of life was assessed at baseline, at 30 days and 12 months with the EQ-5D questionnaire, a prominent instrument to measure health-related quality of life. The study used quality of life data for a total of 415 patients who survived 12 months after TAVI (average age 81.9 ± 5.9 years; men 37.3%). At 12 months, TAVI patients reported improvements with regard to each single dimension of the EQ-5D. In particular the distribution of the three levels (no problems, some problems, extreme problems) changed with regard to usual activities (see figure 1) and discomfort (see figure 2) after 12 months.
For usual activities, the proportion of patients with no problems rose from 17.5% to 48.6%, with some problems decreased from 72.5% to 39.7%, and with extreme problems increased slightly from 10.1% to 11.7%. For discomfort, the proportion of patients with no problems rose from 22.7% to 61.9%, with some problems decreased from 69.1% to 33.3%, and with extreme problems decreased from 8.3% to 4.8%. Professor Neumann said: "Patients gain improvements in their usual activities and feel more comfortable."
He added: "One of the main findings of our study is a remarkable increase in patients' self-ratings of quality of life after TAVI." Scores on the visual analogue health scale (EQ VAS), which records the patient's self-rated health on a vertical, visual analogue scale, significantly improved from a mean value of 44.7% ± 16.5 at baseline to 62.9% ± 17.4 at 30 days. However, even more important was the fact that this benefit in quality of life was sustained, as indicated by the patient's self-rated health status after one year (65.1% ± 20.6; see figure 3).
"Our results demonstrate that the minimal invasive procedure of TAVI does not only save lives but also leads to a remarkable improvement in health-related quality of life in a real world setting," said Professor Neumann. "This benefit in quality of life lasts for a long time period."
He continued: "Patients with severe aortic stenosis can profit from TAVI – the gain in health-related quality of life confirms this. Our findings regarding quality of life could give further impetus to the argument for performing TAVI in older patients with severe aortic stenosis."
Provided by European Society of Cardiology
- Transcatheter aortic valve implantation shows promise in patients with severe aortic stenosis Apr 10, 2012 | not rated yet | 0
- Surgical aortic valve replacement should remain the standard treatment for aortic stenosis Oct 20, 2010 | not rated yet | 0
- Gender differences in clinical presentation and outcome of transcatheter aortic valve implantation Aug 29, 2011 | not rated yet | 0
- Transcatheter aortic valve implantation as good as traditional surgery for high risk, operable patients Apr 05, 2011 | not rated yet | 0
- Expandable prosthesis resolves advanced aortic valve disease Sep 30, 2011 | not rated yet | 0
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Question of reflection and transmission of TEM wave in normal incidenc
3 hours ago Suppose TEM wave in +z normal to a boundary on xy plane at z=0. We know *E* & *H* are tangential to the boundary. Let ##\vec E_i=\hat x E##, be the...
the rudyak-krasnolutski effective potencial
4 hours ago Hi ... anyone now how to calculate or the formula of the rudyak-krasnolutski EFFECTIVE potencial ? the effective potencial includes the angular...
Normal force for a lever model
5 hours ago My model is a lever on a table top. One arm is horizontal on the table, while the other arm is raised at an angle alpha. I'm assuming the weight of...
gravity is std. therefore can we rate a 'mass at height' by watts?
11 hours ago For example.... wind turbines are primarily listed by their wattage (1.5MW etc.) Presumably their output is varied according to rotational speed, so...
Calculating on-axis elements of a solenoid
23 hours ago I wanted to mention that this solenoid has many winds over many layers. The thickness of the windings is 2.4 inches coming off of the engineering...
latitude & longitude & air pressure
May 22, 2013 Hi there, I have a peculiar question. Imagine that you are in a earth position, obtained by google, that gives you the latitude and longitude....
- More from Physics Forums - Classical Physics
More news stories
(HealthDay)—In patients who have previously been considered difficult to image, dual-source cardiac (DSC) computed tomography (CT) can identify clinically significant coronary artery disease, according ...
Cardiology 2 hours ago | not rated yet | 0
UCLA researchers examining outcomes for advanced heart-failure patients over the past two decades have found that, coinciding with the increased availability and use of new therapies, overall mortality has decreased and sudden ...
Cardiology 4 hours ago | not rated yet | 0
22 May 2013, Paris, France: The Lotus Valve, a second-generation transcatheter aortic valve implantation (TAVI) device, was successfully implanted in all of the first 60 patients in results from REPRISE II reported at EuroPCR ...
Cardiology 9 hours ago | not rated yet | 0
Costs to treat stroke are projected to more than double and the number of people having strokes may increase 20 percent by 2030, according to the American Heart Association/American Stroke Association.
Cardiology May 22, 2013 | not rated yet | 0
Blood thinners are the preferred treatment option to prevent heart attacks, blood clots and stroke, but they are not without risk, and not just because of their side effects. These high-risk drugs, known as anticoagulants, ...
Cardiology May 22, 2013 | not rated yet | 0
(HealthDay)—Type 2 diabetes is more aggressive in children than adults, with signs of serious complications seen just a few years after diagnosis, new research finds.
13 minutes ago | not rated yet | 0
2 hours ago | 4.7 / 5 (3) | 0 |
6 hours ago | 5 / 5 (2) | 0 |
6 hours ago | 5 / 5 (1) | 1 |
Little is known about why asthma develops, how it constricts the airway or why response to treatments varies between patients. Now, a team of researchers at Weill Cornell Medical College, Columbia University Medical Center ...
6 hours ago | not rated yet | 0 |
8 hours ago | 4.9 / 5 (7) | 0 |