1. Lindman BR, Clavel M-A, Mathieu P, Iung B, Lancellotti P, Otto CM, Pibarot
P (2016) Calcific aortic stenosis. Nat Rev Dis Primers 2:16006
2. Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Bärwolf C, Levang OW,
Tornos P, Vanoverschelde J-L, Vermeer F, Boersma E, Ravaud P, Vahanian
A. A prospective survey of patients with valvular heart disease in Europe
(2003) The Euro Heart Survey on Valvular Heart Disease. Eur Heart J
24:1231-1243
3. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, Tuzcu
EM, Webb JG, Fontana GP, Makkar RR, Brown DL, Block PC, Guyton RA,
Pichard AD, Bavaria JE, Herrmann HC, Douglas PS, Petersen JL, Akin JJ,
Anderson WN, Wang D, Pocock S (2010) Transcatheter Aortic-Valve
Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery. N
Engl J Med 363:1597-1607
4. Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK,
Thourani VH, Tuzcu EM, Miller DC, Herrmann HC, Doshi D, Cohen DJ,
Pichard AD, Kapadia S, Dewey T, Babaliaros V, Szeto WY, Williams MR,
Kereiakes D, Zajarias A, Greason KL, Whisenant BK, Hodson RW, Moses
28
JW, Trento A, Brown DL, Fearon WF, Pibarot P, Hahn RT, Jaber WA,
Anderson WN, Alu MC, Webb JG (2016) Transcatheter or Surgical AorticValve Replacement in Intermediate-Risk Patients. N Engl J Med 374:16091620
5. Grimaldi A, Figini F, Maisano F, Montorfano M, Chieffo A, Latib A, Pappalardo
F, Spagnolo P, Cioni M, Vermi AC, Ferrarello S, Piraino D, Cammalleri V,
Ammirati E, Sacco FM, Arendar I, Collu E, La Canna G, Alfieri O, Colombo A
(2013) Clinical outcome and quality of life in octogenarians following
transcatheter aortic valve implantation (TAVI) for symptomatic aortic stenosis.
Int J Cardiol 168:281-286
6. Arnold SV, Reynolds MR, Lei Y, Magnuson EA, Kirtane AJ, Kodali SK,
Zajarias A, Thourani VH, Green P, Rodés-Cabau J, Beohar N, Mack MJ, Leon
MB, Cohen DJ (2014) Predictors of Poor Outcomes After Transcatheter Aortic
Valve Replacement. Circulation 129:2682-2690
7. Hiltrop N, Belmans A, Claes M, Hornikx M, Peeters B, Flamaing J,
Adriaenssens T, De Praetere H, Herregods M-C, Herijgers P, Dubois C (2016)
Functional performance and quality of life in high-risk comorbid patients
undergoing transcatheter aortic valve implantation for symptomatic aortic
29
valve stenosis. Eur Heart J Qual Care Clin Outcomes 2:184-192
8. Mehilli J, Chandrasekhar J, Sartori S, Chieffo A, Petronio AS, Lefèvre T,
Presbitero P, Capranzano P, Tchetche D, Iadanza A, Sardella G, Van
Mieghem NM, Meliga E, Dumonteil N, Fraccaro C, Trabattoni D, Jochheim D,
Zadrozny M, Mikhail GW, Sharma S, Ferrer MC, Naber C, Kievit P, Moalem
K, Baber U, Snyder C, Sharma M, Morice MC, Mehran R (2019) Impact of
Discharge Location After Transcatheter Aortic Valve Replacement on 1-Year
Outcomes in Women: Results From the WIN-TAVI Registry. Can J Cardiol
35:199-207
9. Li Z, Dawson E, Moodie J, Martin J, Bagur R, Cheng D, Kiaii B, John-Baptiste
A (2019) Frailty in patients undergoing transcatheter aortic valve implantation:
a protocol for a systematic review. BMJ Open 9:e024163-e024163
10. Ogawa M, Satomi-Kobayashi S, Yoshida N, Tsuboi Y, Komaki K, Wakida K,
Gotake Y, Izawa KP, Sakai Y, Okada K (2019) Effects of Acute Phase
Multidisciplinary Rehabilitation on Unplanned Readmissions After Cardiac
Surgery. J Thorac Cardiovasc Surg doi: 10.1016/j.jtcvs.2019.11.069
11. Kleczynski P, Dziewierz A, Bagienski M, Rzeszutko L, Sorysz D, Trebacz J,
Sobczynski R, Tomala M, Stapor M, Dudek D (2017) Impact of frailty on
30
mortality after transcatheter aortic valve implantation. Am Heart J 185:52-58
12. Afilalo J, Lauck S, Kim DH, Lefèvre T, Piazza N, Lachapelle K, Martucci G,
Lamy A, Labinaz M, Peterson MD, Arora RC, Noiseux N, Rassi A, Palacios
IF, Généreux P, Lindman BR, Asgar AW, Kim CA, Trnkus A, Morais JA,
Langlois Y, Rudski LG, Morin J-F, Popma JJ, Webb JG, Perrault LP (2017)
Frailty in Older Adults Undergoing Aortic Valve Replacement: The FRAILTYAVR Study. J Am Coll Cardiol 70:689-700
13. Otto CM, Kumbhani DJ, Alexander KP, Calhoon JH, Desai MY, Kaul S, Lee
JC, Ruiz CE, Vassileva CM (2017) 2017 ACC Expert Consensus Decision
Pathway for Transcatheter Aortic Valve Replacement in the Management of
Adults With Aortic Stenosis: A Report of the American College of Cardiology
Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol
69:1313-1346
14. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA,
O’Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM, Thomas JD (2014)
2014 AHA/ACC Guideline for the Management of Patients With Valvular
Heart Disease. A Report of the American College of Cardiology/American
Heart Association Task Force on Practice Guidelines. Circulation 129:e521-
31
e643
15. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B,
Lancellotti P, Lansac E, Rodriguez Muñoz D, Rosenhek R, Sjögren J, Tornos
Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Zamorano JL, Group
ESD (2017) 2017 ESC/EACTS Guidelines for the management of valvular
heart disease. Eur Heart J. 2017;38:2739-2791
16. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA,
Jneid H, Mack MJ, McLeod CJ, O’Gara PT, Rigolin VH, Sundt TM, Thompson
A (2017) 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline
for the Management of Patients With Valvular Heart Disease: A Report of the
American College of Cardiology/American Heart Association Task Force on
Clinical Practice Guidelines. Circulation 135:e1159-e1195
17. Nashef SAM, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR,
Lockowandt U (2012) EuroSCORE II†. Eur J Cardiothorac Surg 41:734-745
18. Shahian DM, Jacobs JP, Badhwar V, Kurlansky PA, Furnary AP, Cleveland
JC, Lobdell KW, Vassileva C, Wyler von Ballmoos MC, Thourani VH, Rankin
JS, Edgerton JR, D’Agostino RS, Desai ND, Feng L, He X, O’Brien SM (2018)
The Society of Thoracic Surgeons 2018 Adult Cardiac Surgery Risk Models:
32
Part 1—Background, Design Considerations, and Model Development. Ann
Thorac Surg 105:1411-1418
19. O’Brien SM, Feng L, He X, Xian Y, Jacobs JP, Badhwar V, Kurlansky PA,
Furnary AP, Cleveland JC, Lobdell KW, Vassileva C, Wyler von Ballmoos MC,
Thourani VH, Rankin JS, Edgerton JR, D’Agostino RS, Desai ND, Edwards
FH, Shahian DM (2018) The Society of Thoracic Surgeons 2018 Adult
Cardiac Surgery Risk Models: Part 2—Statistical Methods and Results. Ann
Thorac Surg 105:1419-1428
20. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow
GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC,
Masoudi FA, McBride PE, McMurray JJV, Mitchell JE, Peterson PN, Riegel B,
Sam F, Stevenson LW, Tang WHW, Tsai EJ, Wilkoff BL (2013) 2013
ACCF/AHA Guideline for the Management of Heart Failure. Circulation
128:e240-e327
21. Yoshida N, Yamamoto H, Shinke T, Otake H, Kuroda M, Terashita D,
Takahashi H, Sakaguchi K, Hirota Y, Emoto T, Amin HZ, Mizoguchi T, Hayashi
T, Sasaki N, Yamashita T, Ogawa W, Hirata K-i (2017) Impact of
CD14(++)CD16(+) monocytes on plaque vulnerability in diabetic and non-
33
diabetic patients with asymptomatic coronary artery disease: a crosssectional study. Cardiovasc Diabetol 16:96
22. Teramoto T, Sasaki J, Ishibashi S, Birou S, Daida H, Dohi S, Egusa G, Hiro
T, Hirobe K, Iida M, Kihara S, Kinoshita M, Maruyama C, Ohta T, Okamura T,
Yamashita S, Yokode M, Yokote K (2014) Diagnosis of Atherosclerosis
Executive Summary of the Japan Atherosclerosis Society (JAS) Guidelines
for the Diagnosis and Prevention of Atherosclerotic Cardiovascular Diseases
in Japan―2012 Version. J Atheroscler Thromb 21:296-298
23. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J,
Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA; Cardiovascular Health
Study Collaborative Research Group (2001) Frailty in Older AdultsEvidence
for a Phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146-156.
24. Ogawa M, Izawa KP, Satomi-Kobayashi S, Tsuboi Y, Komaki K, Gotake Y,
Sakai Y, Tanaka H, Okita Y (2017) Impact of delirium on postoperative frailty
and long term cardiovascular events after cardiac surgery. PLoS One
12:e0190359
25. Thomas R, Talbot (2005) Diabetes mellitus and cardiothoracic surgical site
infections. Am J Infect Control 33(6):353-9.
34
26. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin
A, Network AKI (2007) Acute Kidney Injury Network: report of an initiative to
improve outcomes in acute kidney injury. Crit Care 11:R31
27. Bäck C, Hornum M, Olsen PS, Møller CH (2019) 30-day mortality in frail
patients undergoing cardiac surgery: the results of the frailty in cardiac
surgery (FICS) copenhagen study. Scand Cardiovasc J 53:348-354
28. Okoh AK, Chauhan D, Kang N, Haik N, Merlo A, Cohen M, Haik B, Chen C,
Russo MJ (2017) The impact of frailty status on clinical and functional
outcomes after transcatheter aortic valve replacement in nonagenarians with
severe aortic stenosis. Catheter Cardiovasc Interv 90:1000-1006
29. Huded CP, Huded JM, Friedman JL, Benck LR, Lindquist LA, Holly TA, Sweis
RN, Ricciardi MJ, Malaisrie SC, Davidson CJ, Flaherty JD (2016) Frailty
Status and Outcomes After Transcatheter Aortic Valve Implantation. Am J
Cardiol 117:1966-1971
30. Boxer RS, Wang Z, Walsh SJ, Hager D, Kenny AM (2008) The utility of the 6minute walk test as a measure of frailty in older adults with heart failure. Am
J Geriatr Cardiol 17:7-12
31. Yamada S, Kamiya K, Kono Y (2015) Frailty may be a risk marker for adverse
35
outcome in patients with congestive heart failure. ESC Heart Fail 2:168-170
32. Boxer R, Kleppinger A, Ahmad A, Annis K, Hager D, Kenny A (2010) The 6minute walk is associated with frailty and predicts mortality in older adults with
heart failure. Congest Heart Fail 16:208-13
33. Waite I, Deshpande R, Baghai M, Massey T, Wendler O, Greenwood S (2017)
Home-based preoperative rehabilitation (prehab) to improve physical
function and reduce hospital length of stay for frail patients undergoing
coronary artery bypass graft and valve surgery. J Cardiothorac Surg 12:91
34. Russo N, Compostella L, Tarantini G, Setzu T, Napodano M, Bottio T,
D'Onofrio A, Isabella G, Gerosa G, Iliceto S, Bellotto F (2014) Cardiac
rehabilitation after transcatheter versus surgical prosthetic valve implantation
for aortic stenosis in the elderly. Eur J Prev Cardiol 21:1341-8
35. Eichler S, Salzwedel A, Reibis R, Nothroff J, Harnath A, Schikora M, Butter
C, Wegscheider K, Völler H (2017) Multicomponent cardiac rehabilitation in
patients after transcatheter aortic valve implantation: Predictors of functional
and psychocognitive recovery. Eur J Prev Cardiol 24:257-264
36. Fauchère I, Weber D, Maier W, Altwegg L, Lüscher TF, Grünenfelder J,
Nowak A, Tüller D, Genoni M, Falk V, Hermann M (2014) Rehabilitation after
36
TAVI compared to surgical aortic valve replacement. Int J Cardiol 173:564-6
37. Tarro Genta F, Tidu M, Bouslenko Z, Bertolin F, Salvetti I, Comazzi F,
Giannuzzi P (2017) Cardiac rehabilitation after transcatheter aortic valve
implantation compared to patients after valve replacement. J Cardiovasc Med
(Hagerstown) 18:114-120
38. Tamuleviciute-Prasciene E, Drulyte K, Jurenaite G, Kubilius R, BjarnasonWehrens B (2018) Frailty and Exercise Training: How to Provide Best Care
after Cardiac Surgery or Intervention for Elder Patients with Valvular Heart
Disease. Biomed Res Int 2018:9849475
39. Ogawa M, Izawa P.K, Kitamura A, Satomi-seimi K, Tsuboi Y, Komaki K, Sakai
Y, Tanaka H, Okita Y (2017) Changes in exercise capacity and psychosocial
factors in hospitalized cardiac surgery patients. Res in Cardiovasc Med 6:3844
40. Ofori-Asenso R, Chin KL, Mazidi M, Zomer E, Ilomaki J, Zullo AR, Gasevic D,
Ademi Z, Korhonen MJ, LoGiudice D, Bell JS, Liew D (2019) Global Incidence
of Frailty and Prefrailty Among Community-Dwelling Older Adults: A
Systematic Review and Meta-analysis. JAMA Netw Open: 2:e198398e198398
37
Figure legends
Figure 1 Incidence of postoperative complications among four groups
Data are shown as percentages (%). AKI, acute kidney injury; PMI, pacemaker
implantation; PVM, prolonged ventilator management; SAVR, surgical aortic
valve replacement; TAVR, transcatheter aortic valve replacement
Figure 2 Change in the pre- and postoperative 6MWD
6MWD, 6-min walking distance; SAVR, surgical aortic valve replacement; TAVR,
transcatheter aortic valve replacement *p <0.01, **p <0.001.
Figure 3 Home discharge rate among four groups
Data are shown as percentages (%). SAVR, surgical aortic valve replacement;
TAVR, transcatheter aortic valve replacement.
Figure 4 Data of additional outcomes
ICU, intensive care unit; SAVR, surgical aortic valve replacement; TAVR,
transcatheter aortic valve replacement
38
Table 1. Baseline characteristics and laboratory data of the study
population
P value
All,
SAVR all,
TAVR all,
n = 100
n = 134
P value
SAVR all
Variables
n = 234
SAVR
TAVR
P value
SAVR non-frail
non-frail
frail
n = 80
n = 20
vs.
TAVR non-frail
non-frail
frail
n = 89
n = 45
vs.
TAVR all
vs.
SAVR frail
TAVR frail
Age, years
82.0 ± 6.6
77.3 ± 6.5
85.5 ± 4.2
<0.001
76.5 ± 6.0
80.6 ± 7.4
0.01
85.5 ± 3.7
85.6 ± 5.0
0.9998
BMI, kg/m
22.7 ± 3.7
23.1 ± 3.7
22.4 ± 3.7
0.196
23.2 ± 3.8
22.5 ± 3.3
0.880
23.0 ± 3.5
21.3 ± 3.9
0.052
Female, n (%)
149 (63.7)
51 (52.0)
98 (73.1)
<0.001
38 (47.5)
13 (65.0)
0.161
64 (71.9)
34 (75.6)
0.653
Single living, n (%)
66 (31.6)
17 (17.0)
49 (36.6)
<0.001
11 (13.7)
6 (30.0)
0.084
32 (36.0)
17 (37.8)
0.836
LV dimension diastolic, mm
42.1 ± 6.9
42.8 ± 7.1
41.6 ± 6.7
0.209
43.3 ± 6.6
40.7 ± 8.4
0.417
41.8 ± 6.7
41.3 ± 6.7
0.982
LV Dimension systolic, mm
27.4 ± 6.8
27.2 ± 6.5
27.5 ± 7.1
0.762
27.4 ± 6.6
26.4 ± 6.1
0.940
27.1 ± 7.2
28.2 ± 68
0.839
LVEF, %
62.7 ± 12.3
63.6 ± 11.0
62.1 ± 13.2
0.352
64.3 ± 10.7
60.8 ± 11.7
0.669
63.1 ± 13.2
60.1 ± 13.2
0.531
4.6 ± 4.3
5.0 ± 5.5
4.4 ± 3.2
0.274
5.2 ± 6.1
4.2 ± 1.7
0.748
4.6 ± 3.7
3.8 ± 1.5
0.818
21.2 ± 10.6
20.6 ± 11.0
21.6 ± 10.3
0.520
19.5 ± 9.7
24.6 ± 14.4
0.262
21.1 ± 10.9
22.6 ± 9.0
0.912
Echocardiographic parameters
E/E
41.8 ± 7.3
41.3 ± 8.0
42.2 ± 6.8
0.334
41.4 ± 8.3
40.8 ± 6.9
0.988
41.6 ± 7.3
43.5 ± 5.7
0.500
0.6 ± 0.2
0.6 ± 0.2
0.6 ± 0.2
0.992
0.7 ± 0.2
0.6 ± 0.2
0.527
0.7 ± 0.2
0.6 ± 0.2
0.505
Peak velocity, m/s
4.5 ± 0.6
4.4 ± 0.7
4.5 ± 0.6
0.372
4.5 ± 0.7
4.3 ± 0.8
0.537
4.5 ± 0.5
4.5 ± 0.6
0.963
Mean PG, mmHg
50.4 ± 16.3
51.3 ± 18.6
49.8 ± 14.7
0.509
52.5 ± 18.5
46.8 ± 18.5
0.523
50.5 ± 14.2
48.3 ± 15.6
0.880
Hypertension
104 (44.4)
42 (42.0)
62 (46.2)
0.516
35 (43.8)
7 (35.0)
0.478
41 (46.1)
21 (46.7)
0.948
Diabetes mellitus
74 (20.1)
32 (32.0)
42 (31.3)
0.915
26 (32.5)
6 (30.0)
0.830
24 (27.0)
18 (40.0)
0.124
Dyslipidemia
59 (25.2)
29 (29.0)
30 (22.3)
0.249
24 (30.0)
5 (25.0)
0.659
23 (25.8)
7 (15.6)
0.177
16 (6.8)
8 (8.0)
8 (6.0)
8 (10.0)
0 (0)
7 (7.9)
1 (2.2)
131 (56.0)
70 (70.0)
61 (45.5)
60 (75.0)
10 (50.0)
50 (56.2)
11 (24.4)
LAD, mm
AVA, cm
Comorbidities, n (%)
NYHA, n (%)
<0.001
0.003
<0.001
80 (34.2)
21 (21.0)
59 (44.0)
12 (15.0)
9 (45.0)
31 (34.8)
28 (62.2)
7 (3.0)
1 (1.0)
6 (4.5)
0 (0)
1 (5.0)
1 (1.1)
5 (11.1)
Laboratory data
3.6 ± 0.5
3.8 ± 0.4
3.5 ± 0.5
<0.001
3.9 ± 0.4
3.6 ± 0.5
0.064
3.6 ± 0.5
3.3 ± 0.4
0.003
11.6 ± 1.6
12.2 ± 1.6
11.2 ± 1.5
<0.001
12.3 ± 1.6
11.5 ± 1.6
0.182
11.4 ± 1.5
10.7 ± 1.4
0.041
49.4 ± 19.4
51.0 ± 20.0
48.3 ± 19.0
0.317
53.3 ± 18.9
41.9 ± 22.1
0.099
49.6 ± 17.8
45.8 ± 21.0
0.686
HbA1c, %
6.0 ± 0.7
6.1 ± 0.9
5.9 ± 0.6
0.112
6.1 ± 0.9
6.0 ± 0.7
0.939
6.0 ± 0.6
5.8 ± 0.7
0.923
AST, U/L
24.0 ± 12.6
24.7 ± 10.3
23.4 ± 14.0
0.433
25.1 ± 11.0
28.7 ± 25.2
0.760
23.5 ± 14.2
23.2 ± 13.8
0.999
ALT, U/L
16.7 ± 10.7
18.5 ± 12.2
13.3 ± 9.2
0.023
18.5 ± 12.0
18.8 ± 13.2
0.999
15.6 ± 9.5
14.8 ± 8.9
0.976
ALP, U/L
233.5 ± 91.7
232.7 ± 101.5
233.8 ± 84.1
0.122
224.5 ± 96.7
264.9 ± 115.6
0.288
222.0 ± 71.5
257.2 ± 101.6
0.339
γ-GTP, U/L
28.5 ± 24.3
31.4 ± 25.2
26.4 ± 23.5
0.924
32.1 ± 27.0
28.6 ± 16.2
0.941
24.1 ± 20.7
30.9 ± 28.0
0.151
Total bilirubin, mg/dL
0.7 ± 0.2
0.7 ± 0.2
0.7 ± 0.2
0.720
0.7 ± 0.2
0.6 ± 0.2
0.285
0.7 ± 0.2
0.6 ± 0.2
0.676
CRP, mg/dL
0.4 ± 1.0
0.5 ± 1.2
0.4 ± 0.9
0.339
0.4 ± 1.2
0.8 ± 1.4
0.523
0.3 ± 0.6
0.6 ± 1.3
0.980
T-Cho, mg/dL
172.5 ± 38.1
178.1 ± 40.8
168.5 ± 35.7
0.063
181.1 ± 35.6
165.4 ± 57.3
0.394
169.4 ± 36.7
166.7 ± 33.9
0.501
Triglycerides, mg/dL
116.9 ± 60.4
123.8 ± 64.8
111.9 ± 56.7
0.145
126.3 ± 66.3
113.0 ± 58.7
0.833
106.7 ± 57.5
122.3 ± 54.3
0.427
HDL, mg/dL
54.5 ± 16.3
57.2 ± 18.0
52.7 ± 14.8
0.044
57.8 ± 18.1
54.8 ± 17.8
0.894
54.7 ± 15.6
48.6 ± 12.3
0.018
LDL, mg/dL
104.0 ± 30.2
108.4 ± 32.2
101.0 ± 28.5
0.076
110.1 ± 32.6
101.4 ± 30.2
0.706
102.5 ± 29.3
98.1 ± 26.9
0.863
BNP, pg/mL
400.0 ± 625.1 381.0 ± 610.7 413.1 ± 636.8
0.706
348.5 ± 585.1 505.8 ± 703.5
0.760
333.0 ± 447.3 575.2 ± 891.8
Albumin, g/dL
Hemoglobin, g/dL
eGFR, ml/min/1.73m
0.152
Medications, n (%)
β-blocker
73 (31.2)
35 (35.0)
38 (28.4)
0.278
28(35.0)
7(35.0)
>0.999
26 (29.2)
12(26.7)
0.757
ACE-I
25 (10.7)
11 (11.0)
14 (10.5)
0.892
11(13.8)
0(0)
0.079
8(9.0)
6(13.3)
0.437
ARB
84 (35.9)
39 (39.0)
45 (33.6)
0.393
30(37.5)
9(45.0)
0.539
34(38.2)
11(24.4)
0.111
Statin
84 (35.9)
40 (40.0)
44 (32.8)
0.258
33(41.3)
7(35.0)
0.609
30(33.7)
14(31.1)
0.762
Calcium-channel blocker
103 (44.0)
42 (42.0)
61 (45.5)
0.591
33(41.3)
9(45.0)
0.761
40(44.9)
21(46.7)
0.850
Diuretics
92 (39.3)
33 (33.0)
59 (44.0)
0.088
23(28.8)
10(50.0)
0.071
34(38.2)
25(55.6)
0.056
original logistic EuroSCORE
15.6 ± 10.3
13.5 ± 7.8
20.8 ± 13.5
0.001
STS risk score
8.1 ± 8.5
6.9 ± 3.9
11.7 ± 14.3
0.021
EuroSCORE II
10.2 ± 7.2
6.6 ± 4.0
12.8 ± 7.9
<0.001
6.2 ± 3.3
8.6 ± 6.0
0.450
11.6 ± 6.7
15.4 ± 9.6
0.006
Grip strength, kg
19.6 ± 7.6
23.2 ± 8.1
16.9 ± 6.0
<0.001
24.5 ± 7.9
17.8 ± 6.8
<0.001
19.0 ± 5.5
12.9 ± 4.8
<0.001
Gait speed, m/sec
0.9 ± 0.4
1.0 ± 0.2
0.8 ± 0.4
<0.001
1.1 ± 0.2
0.8 ± 0.3
0.004
0.9 ± 0.4
0.5 ± 0.2
<0.001
<0.001
372.8 ± 82.3
208.5 ± 100.3
<0.001
288.1 ± 94.2
136.3 ± 106.7
<0.001
Risk scoring
Pre-operative physical functions
6MWD, m
281.1 ± 126.6 339.9 ± 108.1 237.2 ± 121.7
Data are shown as mean ± standard deviation, or %. The averages of continuous
variables were compared using either the two-tailed student’s t test. Fisher’s
exact test was used to compare the proportions of categorical variables between
groups. 6MWD, 6-minutes walking test distance; ACEI, angiotensin-converting
enzyme inhibitor; ALP, alkaline phosphatase; ALT, alanine aminotransferase;
ARB, angiotensin receptor blocker; AST, aspartate aminotransferase; AVA, aortic
valve area; BMI, body mass index; BNP, Brain natriuretic peptide; BUN, blood
urea nitrogen; CRP, C-reactive protein; EF, ejection fraction; eGFR, estimated
glomerular filtration rate; γ-GTP, glutamyl transpeptidase; HbA1c, glycated
hemoglobin; HDL-C, high-density lipoprotein cholesterol; LAD, left atrial
diameter; LDL-C, low-density lipoprotein cholesterol; LV, left ventricle; NYHA,
New York Heart Association; PG, pressure gradient; SAVR, surgical aortic valve
replacement; STS, Society of Thoracic Surgeons; TAVR, transcatheter aortic
valve replacement; T-Cho, total cholesterol.
Table 2. Result of 6MWD of pre and post operation
Variables
pre
post
P value
Interaction
F value
P value
All patients
SAVR
339.9 ± 108.1
291.1 ± 109.8
<0.001
27.84
<0.001
TAVR
237.2 ± 121.7
230.9 ± 110.3
0.16
SAVR
non-frail
372.8 ± 82.3
321.9 ± 90.8
<0.001
0.376
0.541
frail
208.5 ± 100.3
167.8 ± 92.5
<0.001
TAVR
non-frail
288.1 ± 94.2
281.1 ± 81.3
0.202
0.057
0.812
frail
136.3 ± 106.7
131.6 ± 91.3
0.537
6MWD, 6-minute walking test distance; SAVR, surgical aortic valve replacement;
TAVR, transcatheter aortic valve replacement.
a Significance
level for the hypothesis of no group effect.
Significance level for the hypothesis of time effect (pre vs. post in the same
group).
Significance level for the hypothesis of no time × group effect.
Table 3. Logistic regression model of home discharge
Univariable
Multivariable
Variable
OR (95% CI)
P value
OR (95% CI)
P value
Age
0.916 (0.866-0.963)
<0.001
0.895 (0.829-0.963)
0.003
Sex, (ref. female)
0.591 (0.301-1.115)
0.106
1.087 (0.463-2.521)
0.846
Intervention, (ref. SAVR)
1.077 (0.592-1.980)
0.809
0.382 (0.136-1.046)
0.061
albumin
2.471 (1.255-5.084)
0.008
1.276 (0.326-2.040)
0.603
CRP
0.762 (0.594-0.946)
0.013
0.764 (0.555-1.016)
0.066
frail
0.168 (0.087-0.319)
<0.001
0.131 (0.058-0.285)
<0.001
single living
0.401 (0.214-0.752)
0.004
0.378 (0.169-0.831)
0.016
CRP, C-reactive protein; CI, confidence interval; OR, odds ratio; SAVR, surgical
aortic valve replacement.
...
論文の公開元へ
