Effects of prosthesis-patient mismatch on cardiac function and clinical outcome after transcatheter aortic valve implantation

Parasca, Catalina A.; Calin, Andreea; Rosca, Monica; Botezatu, Simona; Enache, Roxana; Beladan, Carmen; Deleanu, Dan; Chioncel, Ovidiu; Bubenek-Turconi, Serban; Iliescu, Vlad A.; Popescu, Bogdan A.

doi:10.2478/rjc-2024-0022

Figures & Tables

A. Kaplan-Meier survival plot illustrating cumulative survival in patients with PPMM vs. No-PPMM; B. Kaplan-Meier survival plot illustrating cumulative survival in patients with moderate PPMM vs. severe PPMM vs. No-PPMM; C. Kaplan-Meier survival plot illustrating cumulative survival in patients with predicted PPMM vs. unpredicted PPMM vs. No-PPMM.

j_rjc-2024-0022_tab_010

Angio-CT characteristics	PPM_M group (n=39)	No-PPM_M group (n=25)	p-value
A_Ao, mm²	480.3±93	408.5±86	0.004
d A_Ao, mm	24.6±2.4	22.7±2.3	0.003
Annular eccentricity	0.23±0.05	0.23±0.07	0.886
A_LVOT, mm²	479.8±101	404.4±96	0.005
d A_LVOT	24.6±2.6	22.5±2.5	0.004
Ca score	1087.4±491	998.4±574	0.523
LCC Ca score	309±174	271±195	0.440
RCC Ca score	352±219	280±219	0.218
NCC Ca score	426±251	426±291	0.994
Severe leaflet calcification	5 (13.9%)	2 (8.3%)	0.691
Severe annular calcification	4 (11.1%)	3 (12.5%)	1.000
Severe LVOT calcification	4 (11.1%)	3 (12.5%)	1.000
hLCA	13.5±3.7	13.6±3.4	0.945
hRCA	17.5±2.5	17.1±3.4	0.551
hSTJ	23.2±2.8	22.4±3.1	0.270
NCC sinus	32.8±3.9	30.5±4.1	0.033
LCC sinus	33.1±3.9	30.9±3.9	0.037
RCC sinus	30.3±3.7	28.6±3.8	0.099
Bicuspid valve	9 (25.0%)	3 (12.5%)	0.329
STJ	28.3±4.1	27.1±3.3	0.230
AscAo	35.4±4.5	34.7±4.2	0.569

j_rjc-2024-0022_tab_011

Periprocedural characteristics	Unpredicted PPM_M group (n=39)	Predicted PPM_M group (n=25)	p-value
Valve no.	25.5±2.3	23.5±2.6	0.003
20/23	13 (33.4%)	20 (80.0%)	0.001
26	19 (48.7%)	2 (8.0%)
29	7 (17.9%)	7 (12.0%)
Oversizing (%)	5.7±10.0	10.5±9.8	0.069
Oversizing ≥15%	8 (33.3%)	8 (22.2%)	0.383
Oversizing <0%	3 (12.5%)	9 (25.0%)	0.329
Predilatation	4 (10.3%)	3 (10.3%)	1.000
Postdilatation	12 (48.0%)	3 (7.7%)	<0.001

j_rjc-2024-0022_tab_012

Echocardiographic parameters	Unpredicted PPM_M group (n=39)	Predicted PPM_M group (n=25)	p-value
Aortic stenosis severity
Vmax, m/s	2.3±0.6	2.5±0.3	0.223
Mean gradient, mmHg	13.6±6.8	14.4±4.1	0.616
AVA, cm²	1.3±0.3	1.4±0.6	0.265
AVAi, cm²/m²	0.7±0.2	0.7±0.1	0.871
Aortic regurgitation	0.7±0.6	1.0±0.8	0.165
Left ventricle
LVEF, %	52.3±9.6	56.4±10.3	0.116
LV-GLS, %	-12.8±4.0	-15.8±4.2	0.009
LVMi, g/m²	152.9±44	144.7±40	0.451
LVESVi, ml/m²	26.2±15.1	18.2±9.3	0.012
LVEDVi, ml/m²	54.7±23.7	41.9±15.1	0.011
LVSVi, ml/m²	28.1±11.8	23.1±8.9	0.072
E/A	1.0±0.4	1.1±0.3	0.578
E/e’ septal	21.2±9.1	19.4±10.7	0.490
E/e’ average	17.3±7.1	13.9±5.7	0.061
Mitral regurgitation	1.2±0.5	1.0±0.4	0.066
Left Atrium
LAAi, cm²/m²	14.4±2.4	13.3±2.1	0.077
LAVi, ml/m²	49.1±12.9	45.1±11.2	0.204
LA-GLS, % (LA_ε)	-13.2±5.2	-14.4±7.4	0.456
SSr, s^-1	1.1±2.7	0.8±0.4	0.496
ESr, s^-1	-0.7±0.5	-0.5±0.6	0.311
ASr, s^-1	-1.0±0.6	-0.9±0.6	0.569
Right ventricle
TAPSE, cm/s	21.2±3.8	21.5±3.7	0.801
S’RV, cm/s	11.5±2.5	12.2±2.6	0.257
PASP, mmHg	35.3±10.5	34.2±15.2	0.734
FAC, %	43.0±8.1	42.5±8.4	0.822
RV-GLS, %	-18.3±6.0	-18.0±5.9	0.842
RV-FWLS, %	-22.7±8.5	-22.1±7.3	0.789
RV-IVS, %	-12.5±5.5	-13.4±5.1	0.595
RA, mm	36.7±6.3	37.9±6.9	0.882
RV, mm	34.3±5.8	34.9±6.4	0.713

Clinical characteristics according to PPMM group

Demographic and clinical characteristics	All patients (n=160)	PPM_M group (n=64)	No-PPM_M group (n=96)	p-value
Age (years)	76.5 ± 7.4	76.3±7.8	76.6±7.1	0.818
Sex (female)	75 (46.9%)	37 (57.8%)	38 (39.6%)	0.024
BMI (kg/m2)	27.5 ± 4.7	28.5±5.0	26.9±4.5	0.033
BSA (m2)	1.8 ± 0.2	1.9±0.2	1.8±0.2	0.124
Symptoms
Angina	93 (58.5%)	35 (54.7%)	58 (61.1%)	0.424
Syncope	12 (7.5%)	8 (12.5%)	4 (4.2%)	0.068
Pulmonary oedema	23 (14.5%)	11 (17.2%)	12 (12.6%)	0.423
NYHA functional class	2.8±0.6	2.8±0.5	2.8±0.6	0.466
Class 2	46 (28.9%)	16 (25.0%)	30 (31.6%)	0.659
Class 3	103 (64.8%)	44 (68.8%)	59 (62.1%)
Class 4	10 (6.3%)	4 (6.3%)	6 (6.3%)
Comorbidities
Cardiac
Atrial fibrillation	50 (31.4%)	22 (34.4%)	28 (29.5%)	0.514
CAD	87 (54.7%)	30 (46.9%)	57 (60.0%)	0.103
Prior MI	22(13.8%)	7 (10.9%)	15 (15.8%)	0.385
Prior CABG	8 (5.0%)	1 (1.6%)	7 (7.4%)	0.145
Prior PCI	38 (23.9%)	15 (23.4%)	23 (24.2%)	0.911
Other
Obesity	37 (23.1%)	18 (28.1%)	19 (19.8%)	0.221
Type 2 DM	45 (28.3%)	18 (28.1%)	27 (28.4%)	0.968
Systemic hypertension	142 (88.8%)	59 (92.2%)	83 (86.5%)	0.261
COPD	18 (11.3%)	7 (10.9%)	11 (11.5%)	0.919
Cirrhosis	16 (10.1%)	6 (9.4%)	10 (10.5%)	0.813
PAD	19 (11.9%)	6 (9.4%)	13 (13.7%)	0.411
CKD (≥3)	32 (20.1%)	16 (25.0%)	16 (16.8%)	0.208
Frailty	63 (39.5%)	26 (40.6%)	37 (38.9%)	0.832

Echocardiographic changes after TAVI according to PPMM group

Echocardiographic parameters	PPM_M group (n=64)			No-PPM_M group (n=96)
Echocardiographic parameters	Baseline	1m post-TAVI	p-value	Baseline	1m post TAVI	p-value
	Aortic stenosis severity
Vmax, m/s	4.6±0.8	2.4±0.6	<0.001	4.6±0.7	2.1±0.3	<0.001
Mean gradient, mmHg	57.4±19.4	14.05.8	<0.001	56.3±18.6	10.4±3.1	<0.001
AVA, cm²	0.67±0.3	1.3±0.3	<0.001	0.77±0.3	2.0±0.6	<0.001
AVAi, cm²/m²	0.37±0.2	0.7±0.1	<0.001	0.44±0.2	1.1±0.3	<0.001
Aortic regurgitation	1.2±0.6	0.8±0.6	0.001	1.3±0.7	0.8±0.6	<0.001
	Left ventricle
LVEF, %	51.5±12.6	53.9±10.0	0.242	52.0±11.2	54.3±9.2	0.132
LV-GLS, %	-11.9±4.0	-13.9±4.3	0.008	-12.6±4.3	-14.2±3.6	0.009
LVMi, g/m²	174.7±46	149.7±42	0.002	181.4±50	159.7±40	0.001
LVESVi, ml/m²	27.2±18.2	23.0±13.6	0.147	28.3±15.3	23.7±13.6	0.028
LVEDVi, ml/m²	54.7±20.0	49.6±21.5	0.174	57.4±19.5	50.9±18.0	0.018
LVSVi, ml/m²	27.0±8.7	26.1±10.9	0.606	28.4±8.6	26.7±8.4	0.172
E/A	1.3±0.8	1.0±0.4	0.024	1.1±0.8	0.8±0.5	0.003
E/e’ septal	23.2±13.1	20.5±9.7	0.203	21.6±10.7	18.2±7.1	0.012
E/e’ lateral	17.0±11.3	13.8±6.6	0.062	15.0±8.1	13.8±7.4	0.277
E/e’ average	18.1±9.2	16.0±6.7	0.157	16.6±7.4	15.3±6.7	0.231
Mitral regurgitation	1.3±0.6	1.2±0.5	0.326	1.3±0.6	1.0±0.4	<0.001
	Left Atrium
LAAi, cm²/m²	14.8±2.4	13.9±2.3	0.036	15.0±3.7	14.0±3.5	0.052
LAVi, ml/m²	53.0±13.1	47.5±12.3	0.015	54.4±21.2	48.6±19.7	0.052
LA-GLS, % (LAε)	-10.2±5.5	-13.7±6.1	0.001	-13.8±7.1	-16.9±7.4	0.004
SSr, s^-1	0.50±0.5	1.0±2.1	0.080	0.76±0.6	0.8±0.4	0.476
ESr, s^-1	-0.31±0.5	-0.6±0.5	0.001	-0.38±0.5	-0.5±0.6	0.168
ASr, s^-1	-0.71±0.6	-1.0±0.6	0.024	-0.97±0.6	-1.3±0.6	0.004
	Right ventricle
TAPSE, cm/s	2.0±0.4	21.3±3.7	0.122	2.0±0.4	20.5±3.9	0.712
S’RV, cm/s	10.4±2.9	11.8±2.5	0.004	10.5±3.1	12.4±7.8	0.031
PASP, mmHg	42.0±16.3	34.9±12.4	0.017	37.8±14.3	31.5±11.1	<0.001
FAC, %	40.7±8.1	42.8±8.2	0.211	40.5±8.0	43.0±6.8	0.023
RV-GLS, %	-16.1±5.7	-18.2±5.9	0.039	-17.0±6.3	-18.6±5.6	0.162
RV-FWLS, %	-20.4±7.6	-22.5±8.0	0.111	-22.0±7.5	-23.4±7.4	0.450
RV-IVS, %	-9.2±6.8	-12.8±5.3	0.003	-12.1±5.3	-12.9±4.6	0.393
RA, mm	38.5±8.5	36.8±6.5	0.276	36.9±8.5	35.5±8.3	0.248
RV, mm	35.4±5.6	34.5±6.0	0.613	34.1±6.4	33.2±5.9	0.283

Echocardiographic differences between groups 1-month after TAVI (short-term effects of PPMM on cardiac function)

Echocardiographic parameters	PPM_M group (n=64)	No-PPM_M group (n=96)	p-value
Aortic stenosis severity
Vmax, m/s	2.4±0.6	2.1±0.3	0.001
Mean gradient, mmHg	14.05.8	10.4±3.1	<0.001
AVA, cm²	1.3±0.3	2.0±0.6	<0.001
AVAi, cm²/m²	0.7±0.1	1.1±0.3	<0.001
DVI	0.42±0.1	0.57±0.1	<0.001
Aortic regurgitation	0.8±0.6	0.8±0.6	0.956
Left ventricle
LVEF, %	53.9±10.0	54.3±9.2	0.810
LV-GLS, %	-13.9±4.3	-14.2±3.6	0.674
LVMi, g/m²	149.7±42	159.7±40	0.132
LVESVi, ml/m²	23.0±13.6	23.7±13.6	0.768
LVEDVi, ml/m²	49.6±21.5	50.9±18.0	0.689
LVSVi, ml/m²	26.1±10.9	26.7±8.4	0.723
E/A	1.0±0.4	0.8±0.5	0.019
E/e’ septal	20.5±9.7	18.2±7.1	0.084
E/e’ lateral	13.8±6.6	13.8±7.4	0.987
E/e’ average	16.0±6.7	15.3±6.7	0.504
Mitral regurgitation	1.2±0.5	1.0±0.4	0.118
Left Atrium
LAAi, cm²/m²	13.9±2.3	14.0±3.5	0.980
LAVi, ml/m²	47.5±12.3	48.6±19.7	0.682
LA-GLS, % (LAε)	13.7±6.1	16.9±7.4	0.005
SSr, s^-1	1.0±2.1	0.8±0.4	0.459
ESr, s^-1	-0.6±0.5	-0.5±0.6	0.214
ASr, s^-1	-1.0±0.6	-1.3±0.6	0.013
Right ventricle
TAPSE, cm/s	21.3±3.7	20.5±3.9	0.179
S’RV, cm/s	11.8±2.5	12.4±7.8	0.517
SPAP, mmHg	34.9±12.4	31.5±11.1	0.075
FAC, %	42.8±8.2	43.0±6.8	0.881
RV-GLS, %	-18.2±5.9	-18.6±5.6	0.648
RV-FWLS, %	-22.5±8.0	-23.4±7.4	0.497
RV-IVS, %	-12.8±5.3	-12.9±4.6	0.946
RA, mm	36.8±6.5	35.5±8.3	0.270
RV, mm	34.5±6.0	33.2±5.9	0.161

j_rjc-2024-0022_tab_006

Echocardiographic characteristics	All patients (n=160)	PPM_M group (n=64)	No-PPM_M group (n=96)	p-value
Aortic stenosis severity
Vmax, m/s	4.6±0.8	4.6±0.8	4.6±0.7	0.704
Mean gradient, mmHg	56.7 ±18.9	57.4±19.4	56.3±18.6	0.708
AVA, cm²	0.73±0.3	0.67±0.3	0.77±0.3	0.039
AVAi, cm²/m²	0.41±0.2	0.37±0.2	0.44±0.2	0.015
dLVOT, mm		21.8±2.5	22.3±2.3	0.244
Bicuspid valve AS	30 (20.0%)	11 (19.3%)	19 (20.4%)	0.866
Aortic regurgitation	1.2±0.7	1.2±0.6	1.3±0.7	0.486
Left ventricle
LVEF, %	51.8±11.8	51.5±12.6	52.0±11.2	0.781
LVESVi, ml/m²	27.9±16.5	27.2±18.2	28.3±15.3	0.677
LVEDVi, ml/m²	56.3±20.0	54.7±20.0	57.4±19.5	0.416
LVSVi, ml/m²	27.8±8.6	27.0±8.7	28.4±8.6	0.330
LV-GLS, %	-12.3±4.2	-11.9±4.0	-12.6±4.3	0.276
LVMi, g/m²	178.7±48.9	174.7±46	181.4±50	0.396
E/A	1.2±0.8	1.3±0.8	1.1±0.8	0.227
E/e’ septal	22.3±11.7	23.2±13.1	21.6±10.7	0.420
E/e’ lateral	15.9±9.6	17.0±11.3	15.0±8.1	0.217
E/e’ average	17.2±8.3	18.1±9.2	16.6±7.4	0.250
Mitral regurgitation	1.3±0.6	1.3±0.6	1.3±0.6	0.735
Left atrium
LAAi, cm²/m²	14.9±3.2	14.8±2.4	15.0±3.7	0.783
LAVi, ml/m²	53.8±18.4	53.0±13.1	54.4±21.2	0.607
LA-GLS, % (LA_ε)	12.3±6.7	10.2±5.5	13.8±7.1	0.001
SSr, s^-1	0.66±0.6	0.50±0.5	0.76±0.6	0.007
ESr, s^-1	-0.35±0.5	-0.31±0.5	-0.38±0.5	0.385
ASr, s^-1	-0.88±0.6	-0.71±0.6	-0.97±0.6	0.033
Right ventricle
TAPSE, cm	2.0±0.4	2.0±0.4	2.0±0.4	0.968
S’RV, cm/s	10.5±3.0	10.4±2.9	10.5±3.1	0.745
SPAP, mmHg	40.5±15	42.0±16.3	37.8±14.3	0.244
FAC, %	40.7±8.1	40.7±8.1	40.5±8.0	0.740
RV-GLS, %	-16.8±6.1	-16.1±5.7	-17.0±6.3	0.185
RV-FWLS, %	-21.5±7.6	-20.4±7.6	-22.0±7.5	0.071
RV-IVS, %	-11.0±6.1	-9.2±6.8	-12.1±5.3	0.006
RA, mm	37.5±8.5	38.5±8.5	36.9±8.5	0.306
RV, mm	34.5±6.1	35.4±5.6	34.1±6.4	0.352

Univariable and multivariable predictors of PPMM (binary logistic regression)

Regresion analysis	PPM_M (Model 1)				Unpredicted PPM_M (Model 2)				Predicted PPM_M (Model 3)
Regresion analysis	Univariable		Multivariable		Univariable		Multivariable		Univariable		Multivariable
Univariable regression analysis	OR	p-value	OR	p-value	OR	p-value	OR	p-value	OR	p-value	OR	p-value
Perioperative characteristics
Age	0.99	0.590			0.97	0.279			1.04	0.292
Sex (f)	2.09	0.024			0.96	0.917			4.47	0.003
BMI	1.08	0.032	1.10	0.012	0.96	0.337			1.24	<0.001	1.26	<0.001
BSA	3.51	0.108			0.59	0.547			23.7	0.005
Obesity	1.59	0.223			0.66	0.380			3.29	0.009
AAo	0.99	0.018			1.00	0.601			0.99	<0.001
dLVOT	0.87	0.035			1.06	0.459			0.69	<0.001
Ca score	1.000	0.328			1.000	0.780			1.000	0.325
Valve no.	0.809	0.003	0.79	0.001	1.009	0.900			0.639	<0.001	0.584	<0.001
Valve 20/23	2.720	0.003			1.270	0.537			9.500	<0.001
Oversizing	0.981	0.213			0.964	0.043			1.014	0.476
Postdilation	1.327	0.474			0.253	0.031	0.174	0.021	5.011	0.001	3.165	0.040
Postoperative caracteristics (30-day follow-up)
LA-GLS	0.935	0.006	0.921	0.022	0.937	0.019	0.931	0.014	0.972	0.357
LAVI	0.999	0.980			1.004	0.704			0.984	0.317
E/A	3.113	0.034			1.812	0.212			2.243	0.120	2.789	0.074
LVEF	0.996	0.809			0.975	0.178			1.036	0.205
LV-GLS	1.019	0.672			1.124	0.024			0.867	0.028	0.809	0.015
LVMi	0.995	0.133			0.998	0.627			0.991	0.146
PAPS	1.025	0.081			1.022	0.140			1.011	0.529

Predictors of mortality (Cox regression analysis)

Mortality	Univariable analysis			Multivariable analysis
Clinical parameters	HR	95% CI	p-value	HR	95% CI	p-value
PPM_M (measured EOAi)	0.56	0.15-2.09	0.384
PPM_M ≤0.85	2.31	1.04-5.15	0.040	5.92	1.92-18.2	0.002
PPM_M BMI adjusted ≤0.85/0.70	2.45	1.12-5.37	0.025
Valve predicted PPM (prosthesis predicted EOAi)	0.99	0.03-35.8	0.993
Predicted PPM_M	1.05	0.36-3.05	0.936
Unpredicted PPM_M	2.50	1.13-5.50	0.023
Transvalvular mean gradient	1.07	1.00-1.15	0.054
Post-dilation	1.80	0.75-4.32	0.189
LAVi	1.01	1.00-1.03	0.118
LA-GLS	0.94	0.89-1.00	0.050
LA-GLS<19	3.11	1.06-9.12	0.038
E/A	1.95	1.02-3.73	0.044	2.07	0.90-4.77	0.088
LVEF	1.04	0.99-1.04	0.170

j_rjc-2024-0022_tab_007

Angio-CT characteristics	All patients (n=160)	PPM_M group (n=64)	No-PPM_M group (n=96)	p-value
A_Ao, mm²	473.7±90	452.4±95	487.8±84	0.018
d A_Ao, mm	24.4±2.4	23.9±2.5	24.8±2.2	0.012
Annular eccentricity	0.23±0.06	0.23±0.05	0.23±0.07	0.367
A_LVOT, mm²	468.9±101	450.1±105	481.4±97	0.061
d A_LVOT	24.3±2.6	23.8±2.8	24.6±2.5	0.048
Ca score	1112.5±618	1051.8±523	1152.5±673	0.329
LCC Ca score	335.5±226	294±182	362±248	0.067
RCC Ca score	321.1±214	323±220	319±211	0.922
NCC Ca score	457.7±302	426±265	478±324	0.302
Severe leaflet calcification	22 (14.6%)	7 (11.7%)	15 (16.5%)	0.412
Severe annular calcification	20 (13.2%)	7 (11.7%)	13 (14.3%)	0.642
Severe LVOT calcification	17 (11.3%)	7 (11.7%)	10 (11.1%)	0.916
hLCA	14.3±3.7	13.5±3.5	14.9±3.8	0.032
hRCA	18.0±2.9	17.3±2.9	18.5±2.9	0.017
hSTJ	23.1±3.6	22.9±2.9	23.3±3.9	0.494
NCC sinus	32.8±4.1	31.9±4.1	33.3±3.9	0.285
LCC sinus	32.6±4.1	32.3±4.1	32.9±4.2	0.038
RCC sinus	30.5±3.9	29.6±3.8	31.0±4.0	0.030
Bicuspid valve	30 (19.9%)	12 (20%)	18 (19.8%)	0.974
STJ	28.4±4.0	27.8±3.8	28.7±4.1	0.185
AscAo	35.5±5.1	35.1±4.4	35.8±5.5	0.403

j_rjc-2024-0022_tab_008

Periprocedural characteristics	All patients (n=160)	PPM_M group (n=64)	No-PPM_M group (n=96)	p-value
Valve no.	25.4±2.5	24.7±2.6	25.9±2.3	0.004
20/23	60 (37.6%)	33 (51.6%)	27 (28.1%)	0.010
26	65 (40.6%)	21 (32.8%)	44 (45.8%)
29	35 (21.9%)	10 (15.6%)	25 (26.0%)
Oversizing (%)	9.0±11.2	7.6±10.1	10.0±11.9	0.213
Oversizing ≥15%	45 (29.8%)	16 (26.7%)	29 (31.9%)	0.494
Oversizing <0%	28 (18.5%)	12 (20.0%)	16 (17.6%)	0.708
Pre-dilation	20 (13.2%)	7 (11.7%)	13 (14.3%)	0.642
Post-dilation	33 (20.6%)	15 (23.4%)	18 (18.8%)	0.476

j_rjc-2024-0022_tab_009

Echocardiographic characteristics	Unpredicted PPM_M group (n=39)	Predicted PPM_M group (n=25)	p-value
Aortic stenosis severity
Vmax, m/s	4.5±0.8	4.8±0.8	0.104
Mean gradient, mmHg	55.0±18.9	61.3±19.9	0.203
AVA, cm²	0.69±0.3	0.65±0.2	0.618
AVAi, cm²/m²	0.38±0.2	0.35±0.1	0.305
Aortic regurgitation	1.2±0.6	1.2±0.8	0.785
Left ventricle
LVEF, %	49.1±13.3	55.3±10.7	0.055
LVESVi, ml/m²	31.3±20.6	20.7±11.2	0.010
LVEDVi, ml/m²	59.9±23.0	46.7±12.8	0.005
LVSVi, ml/m²	28.1±8.6	25.4±8.8	0.221
LV-GLS, %	-11.6±4.3	-12.3±3.4	0.482
LVMi, g/m²	178.4±42	169.0±52	0.432
E/A	1.5±0.9	1.1±0.5	0.103
E/e’ septal	24.0±12.9	19.3±13.6	0.525
E/e’ average	19.3±10.3	16.2±6.9	0.186
Mitral regurgitation	1.4±0.7	1.1±0.4	0.041
Left atrium
LAAi, cm²/m²	15.4±2.5	14.0±2.0	0.027
LAVi, ml/m²	55.2±13.7	49.6±11.6	0.093
LA-GLS, % (LA_ε)	-9.6±4.8	-11.2±6.4	0.236
SSr, s^-1	0.45±0.5	0.58±0.5	0.305
ESr, s^-1	-0.32±0.5	-0.30±0.5	0.927
ASr, s^-1	-0.67±0.6	-0.76±0.7	0.614
Right ventricle
TAPSE, cm	2.0±0.4	2.1±0.4	0.711
S’RV, cm/s	10.0±2.6	11.0±3.0	0.134
PASP, mmHg	42.3±16.7	39.2±15.2	0.459
FAC, %	40.5±8.4	41.7±8.4	0.581
RV-GLS, %	-15.6±5.5	-16.5±5.8	0.555
RV-FWLS, %	-20.3±7.4	-20.0±7.3	0.876
RV-IVS, %	-10.2±5.3	-8.0±8.1	0.221
RA, mm	39.1±9.8	37.1±6.5	0.373
RV, mm	35.0±6.0	35.2±6.7	0.916

Effects of prosthesis-patient mismatch on cardiac function and clinical outcome after transcatheter aortic valve implantation

Figures & Tables

Figure 1

j_rjc-2024-0022_tab_010

j_rjc-2024-0022_tab_011

j_rjc-2024-0022_tab_012

Clinical characteristics according to PPMM group

Echocardiographic changes after TAVI according to PPMM group

Echocardiographic differences between groups 1-month after TAVI (short-term effects of PPMM on cardiac function)

j_rjc-2024-0022_tab_006

Univariable and multivariable predictors of PPMM (binary logistic regression)

Predictors of mortality (Cox regression analysis)

j_rjc-2024-0022_tab_007

j_rjc-2024-0022_tab_008

j_rjc-2024-0022_tab_009

Paradigm

My account