Evidence map›Paper›PMID 36503424›Full record

ArticleBMC cardiovascular disorders2022

Clinical outcomes of bicuspid versus tricuspid aortic valve stenosis after transcatheter aortic valve replacement with self-expandable valves.

Qinchun Jin, Shasha Chen, Xue Yang, Mingfei Li, Wei Li, Xiaochun Zhang, Daxin Zhou, Yat-Yin Lam, Junbo Ge

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in BMC cardiovascular disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Qinchun Jin *Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, 180 Fenglin Road, 200032, Shanghai, China.
Shasha Chen *Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, 180 Fenglin Road, 200032, Shanghai, China.
Xue Yang *Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Mingfei LiDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, 180 Fenglin Road, 200032, Shanghai, China.
Wei LiDepartment of Echocardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Xiaochun ZhangDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, 180 Fenglin Road, 200032, Shanghai, China. zhang.xiaochun1@zshospital.sh.cn.
Daxin ZhouDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, 180 Fenglin Road, 200032, Shanghai, China. zhou.daxin@outlook.com.
Yat-Yin LamDivision of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, SAR, China. yylam@me.com.
Junbo GeDepartment of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Disease, Fudan University, 180 Fenglin Road, 200032, Shanghai, China.
Fudan University · CNChinese University of Hong Kong · HKSun Yat-sen University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is a lack of available data on specific prognostic comparisons between transcatheter aortic valve replacement (TAVR) using self-expandable valves (SEV) in patients with stenotic Type 0, Type 1 bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV).

objectivesTo evaluate the association between aortic valve morphology and outcomes following self-expandable TAVR.

methodsConsecutive patients with aortic stenosis(AS) undergoing self-expandable TAVR were enrolled and categorized into three groups (Type 0/Type 1 BAV or TAV) according to the Sievers classification. The primary endpoint was a composite of all-cause mortality and rehospitalization for heart failure (HF) within 2 years. Secondary outcomes included procedural complications and major cardiovascular events observed in clinical follow-ups. Clinical outcomes at 2 years following TAVR were compared among three groups using Kaplan-Meier curve and multivariable Cox proportional hazards regression models.

resultsA total of 344 AS patients (Type 0: 86; Type 1: 109; TAV: 149) were enrolled. The presence of moderate or severe paravalvular leak (PVL) was significantly higher in patients with Type 0 and Type 1 BAV versus TAV (10.47% vs. 16.51% vs. 6.71%, p = 0.043). All-cause 30-day mortality (2.33% vs. 0.92% vs. 2.68%, p = 0.626) and 2-year mortality (3.49% vs. 5.50% vs. 6.71%, p = 0.657) was comparable among the three groups. However, rehospitalization for HF within 2 years was significantly higher in Type 1 BAV (11.63% vs. 20.18% vs. 8.72%, p = 0.020). Multivariate Cox analysis showed that a higher STS score, Type 1 BAV morphology and excess leaflet calcification (≥ median calcium volume (CV) of the entire population) were independent predictors for HF rehospitalization. Additional intragroup Kaplan‒Meier analysis showed that excess leaflet calcification could predict higher long-term mortality and rehospitalization risk for HF(HR (95% CI): 3.430 (1.166-10.090), log rank p = 0.017) in Type 1 BAV patients.

conclusionOutcomes of self-expandable TAVR in BAV-AS patients might vary depending on valve subtypes. BAV patients with excess leaflet calcification and a raphe, especially calcified, had an increased risk of moderate PVL and HF readmission in mid-to-long term follow-ups.

Indexed as

Aortic Valve StenosisBicuspid Aortic Valve DiseaseCalcinosisHeart Valve DiseasesTranscatheter Aortic Valve ReplacementAortic ValveHumansTreatment OutcomeBicuspidCalcificationTranscatheter aortic valve replacementTricuspid

Identifiers

PMID36503424
PMCPMC9743542
OpenAlexW4311125278

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.