Dataset related to the article "Outcomes of Transcatheter Aortic Valve Replacement Patients With Different Transvalvular Flow-gradient Patterns"

This record contains raw data related to the article "Outcomes of Transcatheter Aortic Valve Replacement Patients With Different Transvalvular Flow-gradient Patterns".
Low-flow low-gradient (LF-LG) aortic stenosis (AS) may occur with preserved or depressed left ventricular ejection fraction (LVEF). Both situations represent the most challenging subset of patients to manage and generally have a poor prognosis. Few and controversial data exist on the outcomes of these patients compared to normal-flow high-gradient (NF-HG) AS following transcatheter aortic valve replacement (TAVR). We sought to characterize different transvalvular flow-gradient patterns and to examine their prognostic value after TAVR. We enrolled 1208 patients with severe AS and categorized as follow: 976 patients NF-HG (mean aortic pressure gradient, MPG≥40mmHg), 107 paradoxical cLF-LG (pLF-LG, MPG<40mmHg, LVEF≥50%, stroke volume index, SVi<35mL/m2), and 125 cLF-LG (MPG<40mmHg, LVEF<50%, SVi<35mL/m2). When compared with NF-HG and pLF-LG, cLF-LG had a worse symptomatic status (NYHA III-IV 86% vs 62% and 67%, p<0.001), a higher prevalence of eccentric hypertrophy and a higher level of LV global afterload reflected by a higher valvuloarterial impedance. Valvular function after TAVR was excellent over time in all patients. While 30-day mortality (p=0.911) did not differ significantly among groups, cLF-LG had a lower 5-year survival rate (LF-LG 50% vs pLF-LG 62% and NF-HG 68%, p<0.05). cLF-LG was associated with a hazard ratio for mortality of 2.41 (95% CI: 1.65-3.52, p<0.001). In conclusion, TAVR is an effective procedure regardless of transvalvular flow-gradient patterns. However, special care should be given to characterized hemodynamic of AS, as patients with pLF-LG had similar survival rates than patients with NF-HG, whereas cLF-LG is associated with a 2-fold increased risk of mortality at 5-year follow-up.