Title: A novel echo-parameter supersedes the Society of ...

[Pages:30]medRxiv preprint doi: ; this version posted September 27, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

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Title: A novel echo-parameter supersedes the Society of Thoracic Surgeons risk score in predicting 1-year mortality in patients undergoing transcatheter aortic valve replacement Running title: Simple but effective Authors: Chieh-Ju Chao, MD1,2, Pradyumma Agasthi, MD1,2, Amith R Seri, MBBS1, Timothy Barry, BAO1, Anusha Shanbhag, MD1, Yuxiang Wang, MD1, Mackram Eleid, MD2, David Fortuin, MD1, John P. Sweeney, MD1, Peter Pollak, MD3, Abdallah El Sabbagh, MD3, Steven J. Lester, MD1, William K Freeman, MD1, Tasneem Z. Naqvi, MD1, David R Holmes, MD2, Christopher P. Appleton, MD1, and Reza Arsanjani, MD1

1 Department of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona 2 Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, Minnesota 3 Department of Cardiovascular Diseases, Mayo Clinic Florida, Jacksonville, Florida

Disclosure: None.

Copyright: ? [2021] Mayo Foundation for Medical Education and Research. All rights reserved.

Address of correspondence: Chieh-Ju Chao, MD Assistant Professor of Medicine Department of Cardiovascular Diseases, Mayo Clinic Rochester Room Go 6-160, 200 1st St SW, Rochester, MN 55905 Email: chao.chiehju@mayo.edu Twitter: @chiehjuchao1

NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.

medRxiv preprint doi: ; this version posted September 27, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

All rights reserved. No reuse allowed without permission.

Abstract Objectives

We proposed several new echo-parameters (augmented blood pressure) derived from blood pressure and aortic valve gradient measurements and hypothesized that they can accurately predict 1-year mortality post-TAVR.

Background In the era of transcatheter aortic valve replacement (TAVR), predicting post-procedural outcome of patients is one of the most important goals in structural heart research.

Methods Patients in the Mayo Clinic National Cardiovascular Diseases Registry (NCDR)-TAVR database who underwent TAVR between January 1, 2012 and June 30, 2017 were identified to retrieve baseline demographics, STS risk score, ECG, cardiac computed tomography, echocardiographic and mortality data. Augmented blood pressure parameters and valvulo-arterial impedance were evaluated by Cox regression. After logistic model generation, receiver operating curve analysis was used to assess the model performance against STS risk score.

Results The final cohort contained 883 patients with the mean age of 81.3?8.5 years old and 58.2% were male. The mean STS risk score was 8.1?5.1. The median follow-up duration was 353 days and one-year all-cause mortality rates was 13.3%. Multivariate Cox regression showed that augmented SBP and augmented MAP parameters were independent predictors of 1-year mortality (all p ................
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