Prognostic impact of remote dielectric sensing value following TAVR

Heart Vessels. 2023 Dec;38(12):1468-1475. doi: 10.1007/s00380-023-02294-1. Epub 2023 Aug 1.

Abstract

Remote dielectric sensing (ReDS) system non-invasively quantifies pulmonary congestion. Re-admission following trans-catheter aortic valve replacement (TAVR) remains an unsolved matter. Residual pulmonary congestion is a strong risk factor of worse clinical outcomes in patients with heart failure. ReDS system may have a prognostic impact in patients undergoing TAVR. Patients who received TAVR and ReDS measurements during index hospitalization between 2021 and 2022 were included. The prognostic impact of ReDS value on the composite endpoint of death or re-admission following index discharge was investigated. Totally, 42 patients (median 84 years, 14 men) were included. Median ReDS value at index discharge was 27% (24%, 30%) and 10 patients had ReDS values > 30%. During a median of 316 (282, 354) days following index discharge, a higher ReDS value at baseline was independently associated with the incidence of composite endpoint with an adjusted hazard ratio of 1.32 (95% confidence interval between 1.10 and 1.58) with a calculated cutoff of 30%, which significantly stratified the cumulative incidence of the composite endpoint (78% in the high ReDS group [N = 10] and 36% in the normal ReDS group [N = 32], p = 0.002). ReDS technology may be a promising tool to predict future clinical outcomes following TAVR by quantifying residual pulmonary congestion. The clinical implication of ReDS-guided aggressive intervention following TAVR remains the next concern.

Keywords: Aortic valve disease; Congestion; Heart failure; Hemodynamics.

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / diagnosis
  • Aortic Valve Stenosis* / etiology
  • Aortic Valve Stenosis* / surgery
  • Humans
  • Lung
  • Male
  • Prognosis
  • Pulmonary Edema* / etiology
  • Risk Factors
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • Treatment Outcome