[Cognitive and quality of life trajectory after either surgical or transcatheter aortic valve replacement in high-risk patients]. in Giornale italiano di cardiologia (2006) / G Ital Cardiol (Rome). 2016 Dec;17(12 Suppl 1):15S-21. doi: 10.1714/2613.26898.
2016
AO Ordine Mauriziano
AO Cuneo
AOU Città della Salute di Torino
ASL Torino 4
Tipo pubblicazione
Observational Study
Autori/Collaboratori (26)Vedi tutti...
Marzocchi A
U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna.
Saia F
U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna.
Savini C
U.O. Cardiochirurgia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna.
et alii...
Abstract
RATIONALE: The impact of transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (AVR) on cognitive status and quality of life in high-risk patients has been incompletely investigated. METHODS: We conducted a prospective, multicenter study including all patients treated with TAVI and high-risk patients undergoing AVR (age ?80 years or logistic EuroSCORE ?15%) at participating centers. Multidimensional geriatric evaluation including Mini Mental State Examination (MMSE), EuroQol 5D (EQ5D) and Minnesota Living With Heart Failure Questionnaire (MLHFQ) were performed at baseline and at 3- and 12-month follow-up. RESULTS: A total of 518 patients (151 AVR and 367 TAVI) were enrolled in 10 Italian institutions. Patients receiving AVR were older (82.7 ± 2.4 years), with a lower logistic EuroSCORE (12.5 ± 7.1%) as compared with TAVI patients (81.5 ± 6.2 years and 19.6 ± 14.0%, respectively, p=0.001 and p<0.001). Overall, 35.5% of patients showed some degree of cognitive impairment at baseline, with no differences between groups. No significant changes in the cognitive status were observed between baseline and follow-up and between groups at any time point. TAVI patients had a lower quality of life at baseline as compared with AVR patients. Generic and heart failure-related quality of life improved significantly after either procedure. CONCLUSIONS: In high-risk patients, both TAVI and AVR are associated with a significant improvement of quality of life up to 1 year without a detrimental effect on cognitive function.
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PMID : 28151531
DOI : 10.1714/2613.26898
Keywords
Risk Assessment; Transcatheter Aortic Valve Replacement/psychology; Quality of Life; Prospective Studies; Italy; Male; Humans; Female; Heart Valve Prosthesis Implantation/psychology; Cognition; Aortic Valve Stenosis/surgery; Aortic Valve/surgery; Aged, 80 and over;