Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic

Joris F. Ooms; Thijmen W. Hokken; Rik Adrichem; Dilay Gunes; Marjo de Ronde-Tillmans; Isabella Kardys; Jeannette Goudzwaard; Francesco Mattace-Raso; Rutger Jan Nuis; Joost Daemen; Nicolas M. Van Mieghem

doi:10.1007/s12471-023-01795-y

Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic

Joris F. Ooms, Thijmen W. Hokken, Rik Adrichem, Dilay Gunes, Marjo de Ronde-Tillmans, Isabella Kardys, Jeannette Goudzwaard, Francesco Mattace-Raso, Rutger Jan Nuis, Joost Daemen, Nicolas M. Van Mieghem^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Introduction:

Delays in the diagnosis and referral of aortic stenosis (AS) during the coronavirus disease 2019 (COVID-19) pandemic may have affected the haemodynamic status of AS patients. We aimed to compare clinical and haemodynamic characteristics of severe AS patients referred for transcatheter aortic valve implantation (TAVI) or balloon aortic valvuloplasty (BAV) before the pandemic versus two subsequent periods.

Methods:

This study compared three 1‑year historical cohorts: a pre-COVID-19 group (PCOV), a 1st-year COVID-19 group (COV-Y1) and a 2nd-year COVID-19 group (COV-Y2). The main parameters were baseline New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP). Demographics, procedural characteristics and 30-day clinical outcomes were assessed. The transition time between heart team decision and TAVI was examined. Pairwise group comparisons were performed (PCOV vs COV-1Y and COV-1Y vs COV-2Y).

Results::

A total of 720 patients were included with 266, 249 and 205 patients in the PCOV, COV-Y1 and COV-Y2 groups, respectively. BAV was performed in 28 patients (4%). NYHA class did not differ across the cohorts. Compared to PCOV, LVEF was slightly lower in COV-Y1 (58% (49–60%) vs 57% (45–60%), p = 0.03); no difference was observed when comparing COV-Y1 and COV-Y2. LVEDP was higher in COV-Y1 than in PCOV (20 mm Hg (16–26 mm Hg) vs 17 mm Hg (13–24 mm Hg), p = 0.01). No difference was found when comparing LVEDP between COV-Y1 and COV-Y2. Thirty-day mortality did not differ between groups. Transition time was reduced in the COVID era. Duration of hospital stay declined over the study period.

Conclusions:

Patients undergoing TAVI during the COVID-19 pandemic had more advanced AS illustrated by lower LVEF and higher LVEDP, but there were no differences in clinical outcome. The TAVI pathway became more efficient.

Original language	English
Pages (from-to)	399-405
Number of pages	7
Journal	Netherlands Heart Journal
Volume	31
Issue number	10
DOIs	https://doi.org/10.1007/s12471-023-01795-y
Publication status	Published - Oct 2023

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Publisher Copyright:
© 2023, The Author(s).

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Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemicFinal published version, 498 KBLicence: CC BY

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Ooms, J. F., Hokken, T. W., Adrichem, R., Gunes, D., de Ronde-Tillmans, M., Kardys, I., Goudzwaard, J., Mattace-Raso, F., Nuis, R. J., Daemen, J., & Van Mieghem, N. M. (2023). Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic. Netherlands Heart Journal, 31(10), 399-405. https://doi.org/10.1007/s12471-023-01795-y

@article{952c22bd8f8c480bbd9790e588bb8d93,

title = "Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic",

abstract = "Introduction: Delays in the diagnosis and referral of aortic stenosis (AS) during the coronavirus disease 2019 (COVID-19) pandemic may have affected the haemodynamic status of AS patients. We aimed to compare clinical and haemodynamic characteristics of severe AS patients referred for transcatheter aortic valve implantation (TAVI) or balloon aortic valvuloplasty (BAV) before the pandemic versus two subsequent periods. Methods: This study compared three 1‑year historical cohorts: a pre-COVID-19 group (PCOV), a 1st-year COVID-19 group (COV-Y1) and a 2nd-year COVID-19 group (COV-Y2). The main parameters were baseline New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP). Demographics, procedural characteristics and 30-day clinical outcomes were assessed. The transition time between heart team decision and TAVI was examined. Pairwise group comparisons were performed (PCOV vs COV-1Y and COV-1Y vs COV-2Y). Results::A total of 720 patients were included with 266, 249 and 205 patients in the PCOV, COV-Y1 and COV-Y2 groups, respectively. BAV was performed in 28 patients (4%). NYHA class did not differ across the cohorts. Compared to PCOV, LVEF was slightly lower in COV-Y1 (58% (49–60%) vs 57% (45–60%), p = 0.03); no difference was observed when comparing COV-Y1 and COV-Y2. LVEDP was higher in COV-Y1 than in PCOV (20 mm Hg (16–26 mm Hg) vs 17 mm Hg (13–24 mm Hg), p = 0.01). No difference was found when comparing LVEDP between COV-Y1 and COV-Y2. Thirty-day mortality did not differ between groups. Transition time was reduced in the COVID era. Duration of hospital stay declined over the study period. Conclusions: Patients undergoing TAVI during the COVID-19 pandemic had more advanced AS illustrated by lower LVEF and higher LVEDP, but there were no differences in clinical outcome. The TAVI pathway became more efficient.",

author = "Ooms, {Joris F.} and Hokken, {Thijmen W.} and Rik Adrichem and Dilay Gunes and {de Ronde-Tillmans}, Marjo and Isabella Kardys and Jeannette Goudzwaard and Francesco Mattace-Raso and Nuis, {Rutger Jan} and Joost Daemen and {Van Mieghem}, {Nicolas M.}",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = oct,

doi = "10.1007/s12471-023-01795-y",

language = "English",

volume = "31",

pages = "399--405",

journal = "Netherlands Heart Journal",

issn = "1568-5888",

publisher = "Bohn Stafleu van Loghum",

number = "10",

}

Ooms, JF , Hokken, TW , Adrichem, R, Gunes, D, de Ronde-Tillmans, M , Kardys, I , Goudzwaard, J , Mattace-Raso, F , Nuis, RJ , Daemen, J & Van Mieghem, NM 2023, 'Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic', Netherlands Heart Journal, vol. 31, no. 10, pp. 399-405. https://doi.org/10.1007/s12471-023-01795-y

TY - JOUR

T1 - Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic

AU - Ooms, Joris F.

AU - Hokken, Thijmen W.

AU - Adrichem, Rik

AU - Gunes, Dilay

AU - de Ronde-Tillmans, Marjo

AU - Kardys, Isabella

AU - Goudzwaard, Jeannette

AU - Mattace-Raso, Francesco

AU - Nuis, Rutger Jan

AU - Daemen, Joost

AU - Van Mieghem, Nicolas M.

PY - 2023/10

Y1 - 2023/10

N2 - Introduction: Delays in the diagnosis and referral of aortic stenosis (AS) during the coronavirus disease 2019 (COVID-19) pandemic may have affected the haemodynamic status of AS patients. We aimed to compare clinical and haemodynamic characteristics of severe AS patients referred for transcatheter aortic valve implantation (TAVI) or balloon aortic valvuloplasty (BAV) before the pandemic versus two subsequent periods. Methods: This study compared three 1‑year historical cohorts: a pre-COVID-19 group (PCOV), a 1st-year COVID-19 group (COV-Y1) and a 2nd-year COVID-19 group (COV-Y2). The main parameters were baseline New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP). Demographics, procedural characteristics and 30-day clinical outcomes were assessed. The transition time between heart team decision and TAVI was examined. Pairwise group comparisons were performed (PCOV vs COV-1Y and COV-1Y vs COV-2Y). Results::A total of 720 patients were included with 266, 249 and 205 patients in the PCOV, COV-Y1 and COV-Y2 groups, respectively. BAV was performed in 28 patients (4%). NYHA class did not differ across the cohorts. Compared to PCOV, LVEF was slightly lower in COV-Y1 (58% (49–60%) vs 57% (45–60%), p = 0.03); no difference was observed when comparing COV-Y1 and COV-Y2. LVEDP was higher in COV-Y1 than in PCOV (20 mm Hg (16–26 mm Hg) vs 17 mm Hg (13–24 mm Hg), p = 0.01). No difference was found when comparing LVEDP between COV-Y1 and COV-Y2. Thirty-day mortality did not differ between groups. Transition time was reduced in the COVID era. Duration of hospital stay declined over the study period. Conclusions: Patients undergoing TAVI during the COVID-19 pandemic had more advanced AS illustrated by lower LVEF and higher LVEDP, but there were no differences in clinical outcome. The TAVI pathway became more efficient.

AB - Introduction: Delays in the diagnosis and referral of aortic stenosis (AS) during the coronavirus disease 2019 (COVID-19) pandemic may have affected the haemodynamic status of AS patients. We aimed to compare clinical and haemodynamic characteristics of severe AS patients referred for transcatheter aortic valve implantation (TAVI) or balloon aortic valvuloplasty (BAV) before the pandemic versus two subsequent periods. Methods: This study compared three 1‑year historical cohorts: a pre-COVID-19 group (PCOV), a 1st-year COVID-19 group (COV-Y1) and a 2nd-year COVID-19 group (COV-Y2). The main parameters were baseline New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP). Demographics, procedural characteristics and 30-day clinical outcomes were assessed. The transition time between heart team decision and TAVI was examined. Pairwise group comparisons were performed (PCOV vs COV-1Y and COV-1Y vs COV-2Y). Results::A total of 720 patients were included with 266, 249 and 205 patients in the PCOV, COV-Y1 and COV-Y2 groups, respectively. BAV was performed in 28 patients (4%). NYHA class did not differ across the cohorts. Compared to PCOV, LVEF was slightly lower in COV-Y1 (58% (49–60%) vs 57% (45–60%), p = 0.03); no difference was observed when comparing COV-Y1 and COV-Y2. LVEDP was higher in COV-Y1 than in PCOV (20 mm Hg (16–26 mm Hg) vs 17 mm Hg (13–24 mm Hg), p = 0.01). No difference was found when comparing LVEDP between COV-Y1 and COV-Y2. Thirty-day mortality did not differ between groups. Transition time was reduced in the COVID era. Duration of hospital stay declined over the study period. Conclusions: Patients undergoing TAVI during the COVID-19 pandemic had more advanced AS illustrated by lower LVEF and higher LVEDP, but there were no differences in clinical outcome. The TAVI pathway became more efficient.

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U2 - 10.1007/s12471-023-01795-y

DO - 10.1007/s12471-023-01795-y

M3 - Article

C2 - 37498468

AN - SCOPUS:85165912094

SN - 1568-5888

VL - 31

SP - 399

EP - 405

JO - Netherlands Heart Journal

JF - Netherlands Heart Journal

IS - 10

ER -

Changing haemodynamic status of patients referred for transcatheter aortic valve intervention during the COVID-19 pandemic

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