Research Article | | Peer-Reviewed

Transcatheter Aortic Valve Replacement Improves the Quality of Life for Patients with Chronic Obstructive Pulmonary Disease

Received: 11 November 2024     Accepted: 25 November 2024     Published: 13 December 2024
Views:       Downloads:
Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a common comorbidity in patients with aortic stenosis and when severe is a surgical aortic valve replacement contraindication. However, the impact of COPD in patients undergoing TAVR is unclear. This study defines TAVR risks/benefits including quality of life, morbidities, and mortality in COPD patients. All patients undergoing TAVR from August 2012 to June 2023 at a single institution were retrospectively reviewed (n = 1565). 1273 patients with preoperative pulmonary function testing were studied. FEV1/FVC and FEV1% predicted were used to separate patients into groups of COPD severity based on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria. Preoperative and postoperative quality of life (QoL) were measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ). Adverse outcomes and mortality at 30-days and 1-year were measured. Severe and very severe COPD patients had significantly higher rates of new onset atrial fibrillation and myocardial infarction compared to patients with no COPD or mild to moderate COPD. There were no statistically significant differences in rates of stroke, permanent pacemaker implantation, 30-day mortality, or 1-year mortality. TAVR improved QoL in all patients regardless of COPD severity or use of home oxygen. Severe COPD patients had the greatest improvement in KCCQ QoL at 30-days and 1-year post-TAVR, while very severe COPD patients had the smallest improvement in KCCQ QoL. Patients with COPD experienced an improvement in quality of life regardless of severity of COPD. Additionally, one year mortality was not significantly different between COPD severity groups. Therefore, TAVR benefits should not be withheld for COPD patients regardless of their severity.

Published in Cardiology and Cardiovascular Research (Volume 8, Issue 4)
DOI 10.11648/j.ccr.20240804.13
Page(s) 104-112
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Structural Heart Disease, Transcatheter Aortic Valve Replacement (TAVR), Chronic Obstructive Pulmonary Disease (COPD)

References
[1] Lauridsen MD, Valentin JB, Strange JE, et al. Mortality in patients with chronic obstructive pulmonary disorder undergoing transcatheter aortic valve replacement: The importance of chronic obstructive pulmonary disease exacerbation. American Heart Journal. 2023; 262: 100-109.
[2] Tamburino C, Capodanno D, Ramondo A, et al. Incidence and predictors of early and late mortality after transcatheter aortic valve implantation in 663 patients with severe aortic stenosis. Circulation. 2011; 123(3): 299-308.
[3] Mok M, Nombela-Franco L, Dumont E, et al. Chronic Obstructive Pulmonary Disease in Patients Undergoing Transcatheter Aortic Valve Implantation: Insights on Clinical Outcomes, Prognostic Markers, and Functional Status Changes. JACC: Cardiovascular Interventions. 2013; 6(10): 1072-1084.
[4] Ando T, Adegbala O, Akintoye E, et al. Is Transcatheter Aortic Valve Replacement Better Than Surgical Aortic Valve Replacement in Patients With Chronic Obstructive Pulmonary Disease? A Nationwide Inpatient Sample Analysis. Journal of the American Heart Association. 2018; 7(7): e008408.
[5] Kwak MJ, Bhise V, Warner MT, et al. National trend of utilization, clinical and economic outcomes of transcatheter aortic valve replacement among patients with chronic obstructive pulmonary disease. Curr Med Res Opin. 2019; 35(8): 1321-1329.
[6] Nuche J, Ternacle J, Avvedimento M, et al. Incidence, predictors, and prognostic significance of impaired functional status early after transcatheter aortic valve replacement. Rev Esp Cardiol (Engl Ed). 2024; 77(5): 396-407.
[7] Xiao F, Yang J, Fan R. Effects of COPD on in-hospital outcomes of transcatheter aortic valve implantation: Results from the National Inpatient Sample database. Clin Cardiol. 2020; 43(12): 1524-1533.
[8] Doldi P, Steffen J, Orban M, et al. Clinical Outcome Following Transcatheter Aortic Valve Implantation in Patients With Chronic Obstructive Pulmonary Disease. JACC: Cardiovascular Interventions. 2022; 15(11): 1188-1190.
[9] Dziewierz A, Tokarek T, Kleczynski P, et al. Impact of chronic obstructive pulmonary disease and frailty on long-term outcomes and quality of life after transcatheter aortic valve implantation. Aging Clin Exp Res. 2018; 30(9): 1033-1040.
[10] Mach M, Koschutnik M, Wilbring M, et al. Impact of COPD on Outcome in Patients Undergoing Transfemoral versus Transapical TAVI. Thorac Cardiovasc Surg. 2019; 67(4): 251-256.
[11] Marzec K, Jaworska-Wilczyńska M, Kowalik I, et al. Comparison of long-term outcomes and risk factors of aortic stenosis treatment in patients undergoing transcatheter aortic valve implantation and surgical aortic valve replacement. Kardiol Pol. 2022; 80(7-8): 792-798.
[12] Myagmardorj R, Nabeta T, Hirasawa K, et al. Association Between Chronic Obstructive Pulmonary Disease and All-Cause Mortality After Aortic Valve Replacement for Aortic Stenosis. Am J Cardiol. 2023; 190: 41-47.
[13] Dvir D, Waksman R, Barbash IM, et al. Outcomes of Patients With Chronic Lung Disease and Severe Aortic Stenosis Treated With Transcatheter Versus Surgical Aortic Valve Replacement or Standard Therapy. Journal of the American College of Cardiology. 2014; 63(3): 269-279.
[14] Patail H, Kompella R, Hoover NE, et al. In-Hospital and One-Year Outcomes of Transcatheter Aortic Valve Replacement in Patients Requiring Supplemental Home Oxygen Use. Cardiol Res. 2023; 14(3): 228-236.
[15] Agustí A, Celli BR, Criner GJ, et al. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Eur Respir J. 2023; 61(4): 2300239.
[16] Généreux P, Piazza N, Alu MC, et al. Valve Academic Research Consortium 3: Updated Endpoint Definitions for Aortic Valve Clinical Research. Journal of the American College of Cardiology. 2021; 77(21): 2717-2746.
[17] Arnold SV, Spertus JA, Vemulapalli S, et al. Quality of Life Outcomes after Transcatheter Aortic Valve Replacement in an Unselected Population. A Report from the STS/ACC TVT Registry™. JAMA Cardiol. 2017; 2(4): 409-416.
Cite This Article
  • APA Style

    Schwartz, G., Row, H., Tupa, J., Matter, A., Sahmoun, A., et al. (2024). Transcatheter Aortic Valve Replacement Improves the Quality of Life for Patients with Chronic Obstructive Pulmonary Disease. Cardiology and Cardiovascular Research, 8(4), 104-112. https://doi.org/10.11648/j.ccr.20240804.13

    Copy | Download

    ACS Style

    Schwartz, G.; Row, H.; Tupa, J.; Matter, A.; Sahmoun, A., et al. Transcatheter Aortic Valve Replacement Improves the Quality of Life for Patients with Chronic Obstructive Pulmonary Disease. Cardiol. Cardiovasc. Res. 2024, 8(4), 104-112. doi: 10.11648/j.ccr.20240804.13

    Copy | Download

    AMA Style

    Schwartz G, Row H, Tupa J, Matter A, Sahmoun A, et al. Transcatheter Aortic Valve Replacement Improves the Quality of Life for Patients with Chronic Obstructive Pulmonary Disease. Cardiol Cardiovasc Res. 2024;8(4):104-112. doi: 10.11648/j.ccr.20240804.13

    Copy | Download

  • @article{10.11648/j.ccr.20240804.13,
      author = {Greta Schwartz and Hunter Row and Jacob Tupa and Ashley Matter and Abe Sahmoun and Thomas Haldis and Cornelius Dyke},
      title = {Transcatheter Aortic Valve Replacement Improves the Quality of Life for Patients with Chronic Obstructive Pulmonary Disease
    },
      journal = {Cardiology and Cardiovascular Research},
      volume = {8},
      number = {4},
      pages = {104-112},
      doi = {10.11648/j.ccr.20240804.13},
      url = {https://doi.org/10.11648/j.ccr.20240804.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20240804.13},
      abstract = {Chronic Obstructive Pulmonary Disease (COPD) is a common comorbidity in patients with aortic stenosis and when severe is a surgical aortic valve replacement contraindication. However, the impact of COPD in patients undergoing TAVR is unclear. This study defines TAVR risks/benefits including quality of life, morbidities, and mortality in COPD patients. All patients undergoing TAVR from August 2012 to June 2023 at a single institution were retrospectively reviewed (n = 1565). 1273 patients with preoperative pulmonary function testing were studied. FEV1/FVC and FEV1% predicted were used to separate patients into groups of COPD severity based on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria. Preoperative and postoperative quality of life (QoL) were measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ). Adverse outcomes and mortality at 30-days and 1-year were measured. Severe and very severe COPD patients had significantly higher rates of new onset atrial fibrillation and myocardial infarction compared to patients with no COPD or mild to moderate COPD. There were no statistically significant differences in rates of stroke, permanent pacemaker implantation, 30-day mortality, or 1-year mortality. TAVR improved QoL in all patients regardless of COPD severity or use of home oxygen. Severe COPD patients had the greatest improvement in KCCQ QoL at 30-days and 1-year post-TAVR, while very severe COPD patients had the smallest improvement in KCCQ QoL. Patients with COPD experienced an improvement in quality of life regardless of severity of COPD. Additionally, one year mortality was not significantly different between COPD severity groups. Therefore, TAVR benefits should not be withheld for COPD patients regardless of their severity.
    },
     year = {2024}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Transcatheter Aortic Valve Replacement Improves the Quality of Life for Patients with Chronic Obstructive Pulmonary Disease
    
    AU  - Greta Schwartz
    AU  - Hunter Row
    AU  - Jacob Tupa
    AU  - Ashley Matter
    AU  - Abe Sahmoun
    AU  - Thomas Haldis
    AU  - Cornelius Dyke
    Y1  - 2024/12/13
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ccr.20240804.13
    DO  - 10.11648/j.ccr.20240804.13
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 104
    EP  - 112
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20240804.13
    AB  - Chronic Obstructive Pulmonary Disease (COPD) is a common comorbidity in patients with aortic stenosis and when severe is a surgical aortic valve replacement contraindication. However, the impact of COPD in patients undergoing TAVR is unclear. This study defines TAVR risks/benefits including quality of life, morbidities, and mortality in COPD patients. All patients undergoing TAVR from August 2012 to June 2023 at a single institution were retrospectively reviewed (n = 1565). 1273 patients with preoperative pulmonary function testing were studied. FEV1/FVC and FEV1% predicted were used to separate patients into groups of COPD severity based on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria. Preoperative and postoperative quality of life (QoL) were measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ). Adverse outcomes and mortality at 30-days and 1-year were measured. Severe and very severe COPD patients had significantly higher rates of new onset atrial fibrillation and myocardial infarction compared to patients with no COPD or mild to moderate COPD. There were no statistically significant differences in rates of stroke, permanent pacemaker implantation, 30-day mortality, or 1-year mortality. TAVR improved QoL in all patients regardless of COPD severity or use of home oxygen. Severe COPD patients had the greatest improvement in KCCQ QoL at 30-days and 1-year post-TAVR, while very severe COPD patients had the smallest improvement in KCCQ QoL. Patients with COPD experienced an improvement in quality of life regardless of severity of COPD. Additionally, one year mortality was not significantly different between COPD severity groups. Therefore, TAVR benefits should not be withheld for COPD patients regardless of their severity.
    
    VL  - 8
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Sections