Original Article

Short-term effects of transcatheter aortic valve implantation on neurohormonal activation, quality of life and six-minute walk test in severe and symptomatic aortic stenosis

Michael Gotzmann^1,*, Tobias Hehen¹, Alfried Germing¹, Michael Lindstaedt¹, Aydan Yazar¹, Axel Laczkovics², Andreas Mügge¹, Waldemar Bojara¹

¹ Cardiology and Angiology, BG University-Hospital Bergmannsheil, Ruhr-University Bochum, Germany;
² Cardiothoracic surgery, BG University-Hospital Bergmannsheil, Ruhr-University Bochum, Germany

Correspondence to: Michael Gotzmann, Cardiology and Angiology, Bergmannsheil - Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, Bochum, 44789, Germany; michael_gotzmann{at}web.de

Accepted 20 October 2009

Objective: This prospective study aimed to determine to what extent clinical symptoms and neurohumoral activation are improved in patients with severe aortic valve stenosis after transcatheter aortic valve implantation (TAVI) with the CoreValve® prosthesis.

Methods: From June 2008 to June 2009 consecutive patients with symptomatic severe aortic valve stenosis (area < 1 cm²), age 75 years with a logistic EuroSCORE 15% or age > 60 years plus additional specified risk factors were evaluated for TAVI.

Examinations of study patients were performed before and 30 days after TAVI and comprised assessment of quality of life (Minnesota living with heart failure questionnaire, [MLHFQ]) six-minute walk test, measurement of B-type natriuretic peptide and echocardiography. Aortic valve prosthesis was inserted retrograde using a femoral arterial or a subclavian artery approach.

Results: In 44 consecutive patients (mean age of 79.1 ± 7 years, 50% women, mean left ventricular ejection fraction 55.8 ± 8.5%) TAVI was successfully performed. Follow-up 30 days after TAVI showed a significantly improved quality of life (baseline 44 ± 19.1 vs. 28 ± 17.5 MLHFQ Score, p < 0.001) and an enhanced distance in the six-minute walk test (baseline 204 ± 103 vs. 266 ± 123 meters, p < 0.001). B-type natriuretic peptide levels were reduced (baseline 725 ± 837 vs. 423 ± 320 pg/mL, p = 0.005).

Conclusions: Our preliminary results show a significant clinical benefit and a reduction of neurohormonal activation in patients with severe and symptomatic aortic valve stenosis early after TAVI.

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