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. 2022 Feb 9:8:746774.
doi: 10.3389/fcvm.2021.746774. eCollection 2021.

Impact of Systemic Inflammatory Response Syndrome on Clinical, Echocardiographic, and Computed Tomographic Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation

Tarek A N Ahmed  1   2 , You-Jeong Ki  1 , You-Jung Choi  1 , Heba M El-Naggar  1   2 , Jeehoon Kang  1 , Jung-Kyu Han  1 , Han-Mo Yang  1 , Kyung Woo Park  1 , Hyun-Jae Kang  1 , Bon-Kwon Koo  1 , Hyo-Soo Kim  1
Affiliations

Impact of Systemic Inflammatory Response Syndrome on Clinical, Echocardiographic, and Computed Tomographic Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation

Tarek A N Ahmed et al. Front Cardiovasc Med. .

Abstract

Background: Systemic inflammatory response syndrome (SIRS) is a systemic insult that has been described with many interventional cardiac procedures. The outcomes of patients undergoing transcatheter aortic valve implantation (TAVI) are thought to be influenced by this syndrome not only on short-term, but also on long-term.

Objective: We assessed the association of SIRS to different clinical, echocardiographic, and computed tomographic (CT) outcomes after TAVI.

Methods: Two hundred and twenty-four consecutive patients undergoing TAVI were enrolled in this study. They were assessed for the occurrence of SIRS within the first 48 h after TAVI. Patients were followed-up for short- and long-term clinical outcomes. Serial echocardiographic follow-ups were conducted at 1-week, 6-months, and 1-year. CT follow-up at 1 year was recorded.

Results: Eighty patients (36%) developed SIRS. Among different parameters, only pre-TAVI total leucocytic count (TLC), pre-TAVI heart rate, and post-TAVI systolic blood pressure independently predicted the occurrence of SIRS. The incidence of HALT was not significantly different between both groups, albeit higher among SIRS patients (p = 0.1) at 1-year CT follow-up. Both groups had similar patterns of LV recovery on serial echocardiography. Long-term follow-up showed that all-cause death, cardiac death, and re-admission for heart failure (HF) or acute coronary syndrome (ACS) were significantly more frequent among SIRS patients. Early safety and clinical efficacy outcomes were more frequently encountered in the SIRS group, while device-related events and time-related valve safety were comparable.

Conclusion: Although SIRS implies an early acute inflammatory status post-TAVI, yet its clinical sequelae seem to extend to long-term clinical outcomes.

Keywords: hypoattenuation leaflet thickening; inflammatory markers; subclinical leaflet thrombosis; systemic inflammatory response syndrome; transcatheter aortic valve implantation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Repeated measures ANOVA for echocardiographic outcomes of; (A) 2-D LVEF, (B) AV mean PG, (C) AVA, (D) LVMI, (E) LAVI, and (F) LV-GLS, showing the within-groups and between-groups effect, as well as SIRS groups and time interactions.
Figure 2
Figure 2
Kaplan Meier survival curves for the outcomes of all-cause death (A), and clinical efficacy composite end-point (B), showing significantly more events among SIRS group, log rank p = 0.0001, and 0.01, respectively.
See this image and copyright information in PMC

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