Possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data

Gianfranco Piccirillo,1 Federica Moscucci,1 Fabiola Mastropietri,1 Claudia Di Iorio,1 Marco Valerio Mariani,1 Marcella Fabietti,1 Gaetana M Stricchiola,1 Ilaria Parrotta,1 Gennaro Sardella,1 Massimo Mancone,1 Damiano Magrì2 1Department of Cardiovascular, Respiratory, Nephrological, Anest...

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Autores principales: Piccirillo G, Moscucci F, Mastropietri F, Di Iorio C, Mariani MV, Fabietti M, Stricchiola GM, Parrotta I, Sardella G, Mancone M, Magrì D
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Publicado: Dove Medical Press 2018
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spelling oai:doaj.org-article:bf32014c018f455d803b5b1eeb14afd92021-12-02T09:04:56ZPossible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data1178-1998https://doaj.org/article/bf32014c018f455d803b5b1eeb14afd92018-09-01T00:00:00Zhttps://www.dovepress.com/possible-predictive-role-of-electrical-risk-score-on-transcatheter-aor-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Gianfranco Piccirillo,1 Federica Moscucci,1 Fabiola Mastropietri,1 Claudia Di Iorio,1 Marco Valerio Mariani,1 Marcella Fabietti,1 Gaetana M Stricchiola,1 Ilaria Parrotta,1 Gennaro Sardella,1 Massimo Mancone,1 Damiano Magrì2 1Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic, and Geriatric Sciences, Policlinico Umberto I, “La Sapienza” University of Rome, Rome, Italy; 2Department of Molecular and Clinical Medicine, S. Andrea Hospital, “Sapienza” University of Rome, Rome, Italy Objectives: To evaluate the predicative power of the electrical risk score (ERS), a noninvasive and inexpensive test obtained by means of a standard 12-lead electrocardiogram (ECG), in a cohort of elderly patients who had undergone transcatheter aortic valve replacement (TAVR).Methods: Survivors and non-survivors after TAVR at 1-year follow-up were compared in respect to the pre-procedural ERS as well as a number of other clinical and instrumental variables. ERS is composed of seven simple ECG markers: heart rate (>75 bpm); QRS duration (>110 ms); left ventricular hypertrophy (Sokolow–Lyon criteria); delayed QRS transition zone (≥ V4); frontal QRS-T angle (>90°); long QTBazett (>450 ms for men and >460 in women) or JTBazett (330 ms for men and >340 ms for women); and long Tpeak to Tend interval (Tp-e) (>89 ms). The trial was registered in ClinicalTrials.gov as NCT03145376.Results: A total of 40 patients were evaluated. During the follow-up, the all-cause mortality rate was 25% (ten patients) with 15% of cardiovascular death (six patients). The ERS was the strongest predictor of all-cause (odds ratio 3.73, 95% CI: 1.44–9.66, P<0.05) or cardiovascular (odds ratio 3.95, 95% CI: 1.09–14.27, P<0.05) mortality. Receiver operating characteristic curves showed that ERS had the widest significant sensitivity-specificity area under the curve (AUC) predicting all-cause (AUC: 0.855, P<0.05) or cardiovascular mortality (AUC: 0.908, P<0.05).Conclusion: ERS seems to be a useful noninvasive tool able to stratify the risk of mortality in 1-year follow-up of TAVR patients. These findings, however, require larger trials to be confirmed. Keywords: aortic stenosis, transaortic valve replacement, electrical risk score, mortality, Tpeak–Tend, QTc, frontal QRS-T anglePiccirillo GMoscucci FMastropietri FDi Iorio CMariani MVFabietti MStricchiola GMParrotta ISardella GMancone MMagrì DDove Medical PressarticleAortic StenosisTransAortic Valve ReplacementElectrical Risk ScoreMortalityT peak-T endQTcfrontal QRS-T angle.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 1657-1667 (2018)
institution DOAJ
collection DOAJ
language EN
topic Aortic Stenosis
TransAortic Valve Replacement
Electrical Risk Score
Mortality
T peak-T end
QTc
frontal QRS-T angle.
Geriatrics
RC952-954.6
spellingShingle Aortic Stenosis
TransAortic Valve Replacement
Electrical Risk Score
Mortality
T peak-T end
QTc
frontal QRS-T angle.
Geriatrics
RC952-954.6
Piccirillo G
Moscucci F
Mastropietri F
Di Iorio C
Mariani MV
Fabietti M
Stricchiola GM
Parrotta I
Sardella G
Mancone M
Magrì D
Possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data
description Gianfranco Piccirillo,1 Federica Moscucci,1 Fabiola Mastropietri,1 Claudia Di Iorio,1 Marco Valerio Mariani,1 Marcella Fabietti,1 Gaetana M Stricchiola,1 Ilaria Parrotta,1 Gennaro Sardella,1 Massimo Mancone,1 Damiano Magrì2 1Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic, and Geriatric Sciences, Policlinico Umberto I, “La Sapienza” University of Rome, Rome, Italy; 2Department of Molecular and Clinical Medicine, S. Andrea Hospital, “Sapienza” University of Rome, Rome, Italy Objectives: To evaluate the predicative power of the electrical risk score (ERS), a noninvasive and inexpensive test obtained by means of a standard 12-lead electrocardiogram (ECG), in a cohort of elderly patients who had undergone transcatheter aortic valve replacement (TAVR).Methods: Survivors and non-survivors after TAVR at 1-year follow-up were compared in respect to the pre-procedural ERS as well as a number of other clinical and instrumental variables. ERS is composed of seven simple ECG markers: heart rate (>75 bpm); QRS duration (>110 ms); left ventricular hypertrophy (Sokolow–Lyon criteria); delayed QRS transition zone (≥ V4); frontal QRS-T angle (>90°); long QTBazett (>450 ms for men and >460 in women) or JTBazett (330 ms for men and >340 ms for women); and long Tpeak to Tend interval (Tp-e) (>89 ms). The trial was registered in ClinicalTrials.gov as NCT03145376.Results: A total of 40 patients were evaluated. During the follow-up, the all-cause mortality rate was 25% (ten patients) with 15% of cardiovascular death (six patients). The ERS was the strongest predictor of all-cause (odds ratio 3.73, 95% CI: 1.44–9.66, P<0.05) or cardiovascular (odds ratio 3.95, 95% CI: 1.09–14.27, P<0.05) mortality. Receiver operating characteristic curves showed that ERS had the widest significant sensitivity-specificity area under the curve (AUC) predicting all-cause (AUC: 0.855, P<0.05) or cardiovascular mortality (AUC: 0.908, P<0.05).Conclusion: ERS seems to be a useful noninvasive tool able to stratify the risk of mortality in 1-year follow-up of TAVR patients. These findings, however, require larger trials to be confirmed. Keywords: aortic stenosis, transaortic valve replacement, electrical risk score, mortality, Tpeak–Tend, QTc, frontal QRS-T angle
format article
author Piccirillo G
Moscucci F
Mastropietri F
Di Iorio C
Mariani MV
Fabietti M
Stricchiola GM
Parrotta I
Sardella G
Mancone M
Magrì D
author_facet Piccirillo G
Moscucci F
Mastropietri F
Di Iorio C
Mariani MV
Fabietti M
Stricchiola GM
Parrotta I
Sardella G
Mancone M
Magrì D
author_sort Piccirillo G
title Possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data
title_short Possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data
title_full Possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data
title_fullStr Possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data
title_full_unstemmed Possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data
title_sort possible predictive role of electrical risk score on transcatheter aortic valve replacement outcomes in older patients: preliminary data
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/bf32014c018f455d803b5b1eeb14afd9
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