Table 3. Hemodynamic Trends.
| Model | Estimate (95% CI) | ||
|---|---|---|---|
| Mean Gradient, mm Hg | EOA, cm2 | DVI | |
| Early hemodynamic trendsa | |||
| TAVR (first postimplantation to 3 mo) | |||
| All patients (2387 mean gradient, 2361 EOA, and 2372 DVI measurements) | 12.1 (11.6-12.5) to 9.2 (9.06-9.41) |
1.63 (1.61-1.64) to 1.72 (1.69-1.75) |
0.509 (0.504-0.515) to 0.537 (0.530-0.545) |
| P valueb | <.001 | <.001 | <.001 |
| Transapical TAVR (1002 mean gradient, 990 EOA, and 994 DVI measurements) | 11.3 (10.6-12.3) to 8.6 (8.31-8.75) |
1.59 (1.54-1.61) to 1.72 (1.68-1.76) |
0.495 (0.478-0.504) to 0.539 (0.530-0.546) |
| P valueb | <.001 | <.001 | <.001 |
| Transfemoral TAVR (1385 mean gradient, 1371 EOA, and 1378 DVI measurements) | 12.5 (12.0-12.9) to 9.7 (9.50-9.91) |
1.65 (1.62-1.67) to 1.71 (1.67-1.77) |
0.516 (0.510-0.521) to 0.533 (0.522-0.547) |
| P valueb | <.001 | .03 | .005 |
| 23-mm Diameter THV (1218 mean gradient, 1203 EOA, and 1208 DVI measurements) | 13.1 (12.5-14.6) to 9.8 (9.61-10.1) |
1.50 (1.48-1.52) to 1.61 (1.57-1.67) |
0.505 (0.497-0.511) to 0.543 (0.531-0.552) |
| P valueb | <.001 | <.001 | <.001 |
| 26-mm Diameter THV (1137 mean gradient, 1126 EOA, and 1132 DVI measurements) | 11.1 (10.7-11.5) to 8.6 (8.38-8.79) |
1.76 (1.74-1.78) to 1.84 (1.79-1.90) |
0.515 (0.508-0.523) to 0.533 (0.517-0.543) |
| P valueb | <.001 | .004 | .04 |
| SAVR (first postimplantation to 3 mo) | |||
| All patients (286 mean gradient, 282 EOA, and 284 DVI measurements) | 10.3 (5.44-18.9) to 10.8 (10.2-11.4) |
1.46 (1.40-1.50) to 1.64 (1.44-1.88) |
0.486 (0.457-0.498) to 0.486 (0.476-0.510) |
| P valueb | .85 | .09 | >.99 |
| Midterm hemodynamic trendsa | |||
| TAVR (3 mo to 5 y) | |||
| All patients (1911 mean gradient, 1900 EOA, and 1901 DVI measurements) | 9.2 (9.06-9.41) to 10.1 (9.80-10.5) |
1.72 (1.69-1.75) to 1.63 (1.61-1.64) |
0.537 (0.530-0.545) to 0.510 (0.505-0.515) |
| P valueb | <.001 | <.001 | <.001 |
| Transapical TAVR (781 mean gradient, 778 EOA, and 778 DVI measurements) | 8.6 (8.31-8.75) to 9.9 (9.45-10.4) |
1.72 (1.68-1.76) to 1.59 (1.56-1.62) |
0.539 (0.530-0.546) to 0.500 (0.494-0.506) |
| P valueb | <.001 | <.001 | <.001 |
| Transfemoral TAVR (1130 mean gradient, 1122 EOA, and 1123 DVI measurements) | 9.7 (9.50-9.91) to 10.4 (10.0-10.8) |
1.71 (1.67-1.77) to 1.65 (1.62-1.67) |
0.533 (0.522-0.547) to 0.516 (0.510-0.521) |
| P valueb | .003 | .03 | .007 |
| 23-mm Diameter THV (974 mean gradient, 969 EOA, and 970 DVI measurements) | 9.8 (9.61-10.1) to 11.2 (10.5-11.8) |
1.61 (1.57-1.67) to 1.50 (1.48-1.52) |
0.543 (0.531-0.552) to 0.506 (0.500-0.512) |
| P valueb | <.001 | <.001 | <.001 |
| 26-mm Diameter THV (912 mean gradient, 906 EOA, and 906 DVI measurements) | 8.6 (8.38-8.79) to 9.0 (8.58-9.28) |
1.84 (1.79-1.90) to 1.77 (1.74-1.78) |
0.533 (0.517-0.543) to 0.515 (0.509-0.523) |
| P valueb | .05 | .004 | .04 |
| SAVR (3 mo to 5 y) | |||
| All patients (206 mean gradient, 204 EOA, and 204 DVI measurements) | 10.8 (10.2-11.4) to 9.9 (8.97-10.9) |
1.64 (1.44-1.88) to 1.46 (1.41-1.50) |
0.486 (0.476-0.510) to 0.486 (0.463-0.498) |
| P valueb | .20 | .09 | .89 |
Abbreviations: DVI, Doppler velocity index; EOA, effective orifice area; SAVR, surgical aortic valve replacement; TAVR, transcatheter aortic valve replacement; THV, transcatheter heart valve.
a
The 95% CIs in this table are not necessarily symmetric and are equivalent to 2 SEs rather than SD. The P values shown test the difference of the mean estimates between the 2 times and indicate statistical but not necessarily clinical significance.
b
Estimates at different points were compared using z test.