ABSTRACT
BACKGROUND: Clinical data regarding the association between the left atrial function index (LAFI) and outcome in patients undergoing transcatheter aortic valve replacement (TAVR) are limited. OBJECTIVES: We aimed to investigate the association between the left atrial function index (LAFI) and outcome in patients undergoing TAVR. METHODS: In this retrospective multicenter study, we assessed baseline LAFI in 733 patients undergoing TAVR for severe aortic stenosis in two German high-volume centers between 2008 and 2019. Based on receiver operating characteristic curves, patients were stratified according to their baseline LAFI into two groups (LAFI ≤ 13.5 vs. LAFI > 13.5) and assessed for post-procedural outcome. The primary endpoint of our study was the 1-year all-cause mortality. RESULTS: Patients with a LAFI ≤ 13.5 had significantly more often atrial fibrillation (p < 0.001), lower LVEF (p < 0.001) and higher levels of NT-proBNP (p < 0.001). After TAVR, a significant improvement in the LAFI as compared to baseline was observed at 12 months after the procedure (28.4 vs. 32.9; p = 0.001). Compared to patients with a LAFI > 13.5, those with a LAFI ≤ 13.5 showed significantly higher rate of 1-year mortality (7.9% vs. 4.0%; p = 0.03). A lower LAFI has been identified as independent predictor of mortality in multivariate analysis (HR (95% CI) 2.0 (1.1-3.9); p = 0.03). CONCLUSION: A reduced LAFI is associated with adverse outcome and an independent predictor of mortality in TAVR patients. TAVR improves LAFI within 12 months after the procedure. Left Atrial Function Index (LAFI) in Patients undergoing Transcatheter Aortic Valve Implantation. A Kaplan-Meier survival analysis of 1-year all-cause mortality in patients with LAFI ≤ 13.5 compared with patients with LAFI > 13.5. Comparing rates of 1-year all-cause mortality between the different LAFI groups, we found a significant association between left atrial function and mortality. LAFI Left atrial function index. B Comparison of the mean LAFI before and after TAVR. After long-term follow-up the LAFI improved significantly. LAFI Left atrial function index; FU follow-up. C Assessment of the left atrial function index using the pre-procedural transthoracic echocardiography. A Measurement of the minimal left atrial volume (LAEDV). B Assessment of the maximal left atrial volume (LAESV).
Subject(s)
Aortic Valve Stenosis , Transcatheter Aortic Valve Replacement , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Aortic Valve Stenosis/diagnosis , Aortic Valve Stenosis/surgery , Atrial Function, Left , Echocardiography/methods , Humans , Retrospective Studies , Risk Factors , Severity of Illness Index , Transcatheter Aortic Valve Replacement/methods , Treatment OutcomeABSTRACT
This study reports for the first time on the synthesis of novel resin@P-Ag2O material and its application for reducing the chloride effect on COD determination of high salinity water. This engineered core-shell nanomaterial with cationic ion exchange resin core and porous Ag2O shell was prepared by facile ion exchange and silver oxidation method at ambient temperature without using toxic chemicals. The material was characterized by FTIR, XRD, SEM, and SEM-EDX mapping. In the chloride removal test, this material gave a high adsorption capacity of ca. 244 mgCl/gAg at the mild condition with high durability after several adsorption-desorption cycles. Moreover, resin@P-Ag2O was applied for removing chloride in water to improve the accuracy of the SMEWW 5220C:2012 method for COD determination of high salinity water. The result showed that the COD of a water sample with salt content after being treated by the material had a low error (≤ 10%) as compared to the sample without salt. Meanwhile, the COD of salty water measured by the dilution method had an error of around 15%. These results indicate that resin@P-Ag2O material has a very potential application for chloride removal and COD determination of high salinity water.