Authors

• Sara Varga — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0009-0005-1125-8108
• Ivana Jurin — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-2637-9691
• Fran Šaler — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-1428-3940
• Vanja Ivanović Mihajlović — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-6931-5404
• Ana Jordan — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-5610-6259
• Anđela Jurišić — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-8316-4294
• Hrvoje Falak — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-6502-683X
• Petra Vitlov — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-6983-1409
• Danijela Grizelj — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-8298-7974
• Nikša Bušić — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-7082-4932
• Šime Manola — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0001-6444-2674
• Ivan Zeljković — Dubrava University Hospital, Zagreb, Croatia — ORCID: 0000-0002-4550-4056

Keywords

estimated plasma volume status, transcatheter aortic valve implantation, heart failure, mortality

DOI

Full Text

**Introduction**: Transcatheter aortic valve intervention (TAVI) has been accepted as an alternative strategy for treating severe aortic valve stenosis (AS) (1). Congestion can worsen outcomes after TAVI and covert congestion can be indirectly assessed by estimated plasma volume status (ePVS) (2). Aim: to assess is high ePVS associated with higher all-cause mortality and major adverse cardiac events (MACE) in short-term (30 days) and long-term (12 months) follow up. **Patients and Methods**: We included patients treated in Dubrava University Hospital from December 2010 to September 2023, who underwent TAVI due to severe AS. We used Strauss-derived Duarte formula (EPVs= (100-hematocrit (%)) ÷ hemoglobin (g/L)) to estimate PVS values at the baseline (iePVS) and two days after TAVI procedure (pePVS). MACE included stroke, bleeding, worsening heart failure (HF) and acute coronary syndrome (ACS). **Results**: This study included 366 patients, median age 80 years, 48% female. Median iePVS was 5.598 (IQR 5.173-6.251) and median pePVS was 6.654 (IQR 6.227-7.375). Values of ePVS higher than median were considered as high. Patients with high iePVS had no significant difference in all-cause mortality or MACE during the short or long term follow up compared to those with low iePVS (p=0.960 for short-term and p=0.357 for long-term all-cause mortality, p=0.414 for short-term and p=0.414 for long-term MACE). However, patients with high pePVS had statistically significant higher all-cause mortality rate compared to patients with low pePVS (p=0.030) in long term follow up. Short term survival was similar in both groups (p=0.373). There was no significant difference in MACE in short (p=0.981) or long-term (p=0.296) follow up between the groups. **Conclusion:** Our results suggest that initial ePVS did not prove to be prognostic for the adverse short- or long-term outcomes of TAVI patients. Postprocedural ePVS predicted higher all-cause mortality in long-term follow up.

Literature

1. Krittanawong C, Virk HUH, Hahn J, Wang Z, Al-Azzam F, Alam M, et al. Clinical Outcome of TAVI vs. SAVR in Patients with Severe Aortic Stenosis. J Clin Med. 2023 August 11;12(16):5236. https://doi.org/10.3390/jcm12165236
2. Maznyczka AM, Barakat M, Aldalati O, Eskandari M, Wollaston A, Tzalamouras V, et al. Calculated plasma volume status predicts outcomes after transcatheter aortic valve implantation. Open Heart. 2020 December;7(2):e001477. https://doi.org/10.1136/openhrt-2020-001477