Vol 24, No 2 (2017)
Original articles — Clinical cardiology
Published online: 2016-09-30

open access

Page views 2131
Article views/downloads 1995
Get Citation

Connect on Social Media

Connect on Social Media

Assessment of cardiovascular function following transcatheter aortic valve implantation based on six-minute walk test

Piotr Chodór, Krzysztof Wilczek, Teresa Zielińska, Roman Przybylski, Jan Głowacki, Łukasz Włoch, Marian Zembala, Zbigniew Kalarus
Pubmed: 27714724
Cardiol J 2017;24(2):167-175.

Abstract

Background: Transcatheter aortic valve implantation (TAVI) is presently a recognized treatment mo­dality for patients with severe aortic stenosis ineligible for surgery. It reduces mortality as compared to the conservative treatment. It is further expected from this therapy to improve quality of life by improving of the cardiovascular function performance. The aim of this study is to compare patients’ cardiovascular system efficiency in the 6-minute walk test (6MWT) made before and after TAVI and at the 6–12-month follow-up.

Methods: From January 2009 until February 2012, in the Silesian Center for Heart Diseases in Zabrze, TAVI was performed in 104 patients. Eighty-two patients who underwent 6MWT before surgery were qualified for the analysis. The average age of the patients was 76.0 ± 9.17 years, women made 45.1%. The risk of surgical treatment according to the Logistic Euroscore averaged 22.76 ± 12.63%, and by the Society of Thoracic Surgeons — 5.55 ± 3.34%. The 6MWT was performed within 1 month before the TAVI procedure, up to a month after the procedure and during the 6–12-month follow-up.

Results: The 6-minute walk test after TAVI was performed by 64 patients, and after 6–12 month follow-up by 46 patients. The average distance in 6MWT increased from 268.4 ± 89.0 m before treat­ment to 290.0 ± 98.2 m after the procedure (p = 0.008) and 276.1 ± 93.5 m to 343.1 ± 96.7 m after 6–12 months (p < 0.0001).

Conclusions: Transcatheter aortic valve implantation procedures significantly improve function of the cardiovascular system evaluated by the 6MWT in 1- and 6–12-month observations. (Cardiol J 2017; 24, 2: 167–175)

Article available in PDF format

View PDF Download PDF file

References

  1. Leon MB, Smith CR, Mack M, et al. PARTNER Trial Investigators. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010; 363(17): 1597–1607.
  2. Smith CR, Leon MB, Mack MJ, et al. PARTNER Trial Investigators. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011; 364(23): 2187–2198.
  3. Adams DH, Popma JJ, Reardon MJ, et al. U.S. CoreValve Clinical Investigators. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med. 2014; 370(19): 1790–1798.
  4. Gotzmann M, Hehen T, Germing A, et al. Short-term effects of transcatheter aortic valve implantation on neurohormonal activation, quality of life and 6-minute walk test in severe and symptomatic aortic stenosis. Heart. 2010; 96(14): 1102–1106.
  5. Bagur R, Rodés-Cabau J, Dumont E, et al. Exercise capacity in patients with severe symptomatic aortic stenosis before and six months after transcatheter aortic valve implantation. Am J Cardiol. 2011; 108(2): 258–264.
  6. Green P, Cohen DJ, Généreux P, et al. Relation between six-minute walk test performance and outcomes after transcatheter aortic valve implantation (from the PARTNER trial). Am J Cardiol. 2013; 112(5): 700–706.
  7. Kleczyński P, Bagieński M, Sorysz D, et al. Short- and intermediate-term improvement of patient quality of life after transcatheter aortic valve implantation: a single-centre study. Kardiol Pol. 2014; 72(7): 612–616.
  8. Chodór P, Wilczek K, Przybylski R, et al. Immediate and 6-month outcomes of transapical and transfemoral Edwards-Sapien prosthesis implantation in patients with aortic stenosis. Kardiol Pol. 2010; 68(10): 1124–1131.
  9. Wilczek K, Chodór P, Walas R, et al. "Vale-in-valve" - first Polish experience in transcatheter treatment of patient with high-risk of redo surgery for degenerative disease of aortic bioprosthesis, using tranaxillary access. Kardiol Pol. 2010; 68(8): 980–984.
  10. Wilczek K, Chodór P, Laborde JC, et al. [Percutaneous transfemoral aortic CoreValve(R) implantations in high risk patients--another Polish good experience]. Kardiol Pol. 2009; 67(10): 1162–1165.
  11. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166(1): 111–117.
  12. Bruce RA. Exercise testing of patients with coronary heart disease. Principles and normal standards for evaluation. Ann Clin Res. 1971; 3(6): 323–332.
  13. Crawford M, O'Rourke RA, Ramakrishna N, et al. Comparative effectiveness of exercise testing and continuous monitoring for detecting arrhythmias in patients with previous myocardial infarction. Circulation. 1974; 50(2): 301–305.
  14. Shaw DJ, Crawford MH, Karliner JS, et al. Arm-crank ergometry: a new method for the evaluation of coronary artery disease. Am J Cardiol. 1974; 33(6): 801–805.