{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:20:43Z","timestamp":1788333643291,"version":"build-2803163510"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T00:00:00Z","timestamp":1686700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Cardiac damage staging has been postulated as a prognostic tool in patients undergoing transcatheter aortic valve replacement (TAVR). The aims of our study are (i) to validate cardiac damage staging systems previously described to stratify patients with aortic stenosis (AS), (ii) to identify independent risk factors for 1-year mortality in patients with severe AS undergoing TAVR, and (iii) to develop a novel staging model and compare its predictive performance to that of the above mentioned.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Patients undergoing TAVR from 2017 to 2021 were included in a single-centre prospective registry. Transthoracic echocardiography was performed in all patients before TAVR. Logistic and Cox\u2019s regression analysis were used to identify predictors of 1-year all-cause mortality. In addition, patients were classified based on previously published cardiac damage staging systems, and the predictive performance of the different scores was measured.<\/jats:p>\n                  <jats:p>Four hundred and ninety-six patients (mean age 82.1 \u00b1 5.9 years, 53% female) were included. Mitral regurgitation (MR), left ventricle global longitudinal strain (LV-GLS) and right ventricular-arterial coupling (RVAc) were independent predictors of all-cause 1-year mortality. A new classification system with four different stages was developed using LV-GLS, MR, and RVAc. The area under the receiver operating characteristic curve was 0.66 (95% confidence interval 0.63\u20130.76), and its predictive performance was superior compared with the previously published systems (P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Cardiac damage staging might have an important role in patients\u2019 selection and better timing for TAVR. A model that includes LV-GLS, MR, and RVAc may help to improve prognostic stratification and contribute to better selection of patients undergoing TAVR.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jead140","type":"journal-article","created":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T19:23:51Z","timestamp":1686684231000},"page":"1608-1617","source":"Crossref","is-referenced-by-count":27,"title":["Redefining cardiac damage staging in aortic stenosis: the value of GLS and RVAc"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0841-4112","authenticated-orcid":false,"given":"Eva","family":"Gutierrez-Ortiz","sequence":"first","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Olmos","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Carri\u00f3n-Sanchez","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Jim\u00e9nez-Quevedo","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Nombela-Franco","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"P\u00e1rraga","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Gil-Abizanda","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mah\u00eda","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Luaces","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Alberto","family":"de Agust\u00edn","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabi\u00e1n","family":"Islas","sequence":"additional","affiliation":[{"name":"Instituto Cardiovascular, Hospital Cl\u00ednico San Carlos, Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdSSC) , Calle Profesor Mart\u00edn Lagos S\/N, Madrid 28040 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"2023112322345734300_jead140-B1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur Heart J"},{"key":"2023112322345734300_jead140-B2","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1001\/jamacardio.2018.3152","article-title":"Outcomes of patients with asymptomatic aortic stenosis followed up in heart valve clinics","volume":"3","author":"Lancellotti","year":"2018","journal-title":"JAMA Cardiol"},{"key":"2023112322345734300_jead140-B3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jcmg.2018.07.029","article-title":"Relationship between left ventricular ejection fraction and mortality in asymptomatic and minimally symptomatic patients with severe aortic stenosis","volume":"12","author":"Bohbot","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023112322345734300_jead140-B4","doi-asserted-by":"crossref","first-page":"e002917","DOI":"10.1161\/CIRCIMAGING.114.002917","article-title":"Effect of left ventricular ejection fraction on postoperative outcome in patients with severe aortic stenosis undergoing aortic valve replacement","volume":"8","author":"Dahl","year":"2015","journal-title":"Circ Cardiovasc Imaging"},{"key":"2023112322345734300_jead140-B5","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jcin.2017.08.036","article-title":"Prognostic impact of left ventricular ejection fraction in patients with severe aortic stenosis","volume":"11","author":"Taniguchi","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"2023112322345734300_jead140-B6","doi-asserted-by":"crossref","first-page":"3351","DOI":"10.1093\/eurheartj\/ehx381","article-title":"Staging classification of aortic stenosis based on the extent of cardiac damage","volume":"38","author":"G\u00e9n\u00e9reux","year":"2017","journal-title":"Eur Heart J"},{"key":"2023112322345734300_jead140-B7","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1001\/jamacardio.2018.4830","article-title":"Association of structural and functional cardiac changes with transcatheter aortic valve replacement outcomes in patients with aortic stenosis","volume":"4","author":"Fukui","year":"2019","journal-title":"JAMA Cardiol"},{"key":"2023112322345734300_jead140-B8","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.jacc.2019.04.065","article-title":"Staging cardiac damage in patients with asymptomatic aortic valve stenosis","volume":"74","author":"Tastet","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2023112322345734300_jead140-B9","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.jacc.2019.05.048","article-title":"Staging cardiac damage in patients with symptomatic aortic valve stenosis","volume":"74","author":"Vollema","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2023112322345734300_jead140-B10","doi-asserted-by":"crossref","first-page":"4563","DOI":"10.3390\/jcm10194563","article-title":"Extent of cardiac damage and mortality in patients undergoing transcatheter aortic valve implantation","volume":"10","author":"Avvedimento","year":"2021","journal-title":"J Clin Med"},{"key":"2023112322345734300_jead140-B11","first-page":"100768","article-title":"Staging cardiac damage associated with aortic stenosis in patients undergoing transcatheter aortic valve implantation","volume":"33","author":"Okuno","year":"2021","journal-title":"Int J Cardiol Heart Vasc"},{"key":"2023112322345734300_jead140-B12","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1093\/ehjqcco\/qcab041","article-title":"Refined staging classification of cardiac damage associated with aortic stenosis and outcomes after transcatheter aortic valve implantation","volume":"7","author":"Okuno","year":"2021","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"2023112322345734300_jead140-B13","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1056\/NEJMoa1912846","article-title":"Early surgery or conservative care for asymptomatic aortic stenosis","volume":"382","author":"Kang","year":"2020","journal-title":"N Engl J Med"},{"key":"2023112322345734300_jead140-B14","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.ahj.2019.02.018","article-title":"Rationale and design of the randomized, controlled early valve replacement guided by biomarkers of left ventricular decompensation in asymptomatic patients with severe aortic stenosis (EVOLVED) trial","volume":"212","author":"Bing","year":"2019","journal-title":"Am Heart J"},{"key":"2023112322345734300_jead140-B15","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.ahj.2016.08.009","article-title":"Rationale and design of the transcatheter aortic valve replacement to UNload the left ventricle in patients with ADvanced heart failure (TAVR UNLOAD) trial","volume":"182","author":"Spitzer","year":"2016","journal-title":"Am Heart J"},{"key":"2023112322345734300_jead140-B16","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023112322345734300_jead140-B17","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/j.echo.2022.04.013","article-title":"Incremental prognostic value of left ventricular global longitudinal strain in patients with preserved ejection fraction undergoing transcatheter aortic valve implantation","volume":"35","author":"Lee","year":"2022","journal-title":"J Am Soc Echocardiogr"},{"key":"2023112322345734300_jead140-B18","doi-asserted-by":"crossref","first-page":"778027","DOI":"10.3389\/fcvm.2022.778027","article-title":"Prognostic value of global longitudinal strain in asymptomatic aortic stenosis: a systematic review and meta-analysis","volume":"9","author":"Wang","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"2023112322345734300_jead140-B19","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1093\/ehjci\/jex189","article-title":"Left ventricular global longitudinal strain is predictive of all-cause mortality independent of aortic stenosis severity and ejection fraction","volume":"19","author":"Ng","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023112322345734300_jead140-B20","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1093\/ehjci\/jeaa220","article-title":"Incremental value of left ventricular global longitudinal strain in a newly proposed staging classification based on cardiac damage in patients with severe aortic stenosis","volume":"21","author":"Vollema","year":"2020","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023112322345734300_jead140-B21","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/j.amjcard.2015.01.022","article-title":"Meta-analysis of the impact of mitral regurgitation on outcomes after transcatheter aortic valve implantation","volume":"115","author":"Chakravarty","year":"2015","journal-title":"Am J Cardiol"},{"key":"2023112322345734300_jead140-B22","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1161\/CIRCULATIONAHA.113.001822","article-title":"Interplay between mitral regurgitation and transcatheter aortic valve replacement with the CoreValve revalving system: a multicenter registry","volume":"128","author":"Bedogni","year":"2013","journal-title":"Circulation"},{"key":"2023112322345734300_jead140-B23","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.echo.2016.08.016","article-title":"Impact of right ventricular dysfunction and tricuspid regurgitation on outcomes in patients undergoing transcatheter aortic valve replacement","volume":"30","author":"Schwartz","year":"2017","journal-title":"J Am Soc Echocardiogr"},{"key":"2023112322345734300_jead140-B24","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ahj.2016.09.018","article-title":"Impact of right ventricular function on outcome of severe aortic stenosis patients undergoing transcatheter aortic valve replacement","volume":"184","author":"Koifman","year":"2017","journal-title":"Am Heart J"},{"key":"2023112322345734300_jead140-B25","doi-asserted-by":"crossref","first-page":"5877","DOI":"10.3390\/jcm10245877","article-title":"Pre-Procedural right ventricular longitudinal strain and post-procedural tricuspid regurgitation predict mortality in patients undergoing transcatheter aortic valve implantation (TAVI)","volume":"10","author":"Omran","year":"2021","journal-title":"J Clin Med"},{"key":"2023112322345734300_jead140-B26","doi-asserted-by":"crossref","first-page":"2963","DOI":"10.21037\/jtd.2020.02.10","article-title":"Tricuspid regurgitation and in-hospital outcomes after transcatheter aortic valve replacement in high-risk patients","volume":"12","author":"Omar","year":"2020","journal-title":"J Thorac Dis"},{"key":"2023112322345734300_jead140-B27","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1016\/j.jcin.2022.07.005","article-title":"Impact of right ventricle-pulmonary artery coupling on clinical outcomes in the PARTNER 3 trial","volume":"15","author":"Cahill","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"2023112322345734300_jead140-B28","first-page":"150","article-title":"Right ventricular deformation and right ventricular-arterial coupling in patients with heart failure due to severe aortic stenosis undergoing TAVI: long-term results","volume":"10","author":"Vizzardi","year":"2020","journal-title":"Am J Cardiovasc Dis"},{"key":"2023112322345734300_jead140-B29","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1136\/heartjnl-2018-313385","article-title":"Right ventricle to pulmonary artery coupling in patients undergoing transcatheter aortic valve implantation","volume":"105","author":"Sultan","year":"2019","journal-title":"Heart"},{"key":"2023112322345734300_jead140-B30","doi-asserted-by":"crossref","first-page":"4364","DOI":"10.3390\/jcm10194364","article-title":"The common combination of aortic stenosis with mitral regurgitation: diagnostic insight and therapeutic implications in the modern era of advanced echocardiography and percutaneous intervention","volume":"10","author":"Mantovani","year":"2021","journal-title":"J Clin Med"},{"key":"2023112322345734300_jead140-B31","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/j.cjca.2019.12.022","article-title":"Clinical impact of preprocedural moderate or severe mitral regurgitation on outcomes after transcatheter aortic valve replacement","volume":"36","author":"Miura","year":"2020","journal-title":"Can J Cardiol"},{"key":"2023112322345734300_jead140-B32","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.1016\/j.jacc.2014.02.573","article-title":"Significant mitral regurgitation left untreated at the time of aortic valve replacement: a comprehensive review of a frequent entity in the transcatheter aortic valve replacement era","volume":"63","author":"Nombela-Franco","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2023112322345734300_jead140-B33","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1016\/j.jacc.2015.08.872","article-title":"Mitral Annulus calcification","volume":"66","author":"Abramowitz","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2023112322345734300_jead140-B34","first-page":"523","article-title":"Prevalence and modifiable risk factors of degenerative valvular heart disease among elderly population in southern China","volume":"18","author":"He","year":"2021","journal-title":"J Geriatr Cardiol"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/advance-article-pdf\/doi\/10.1093\/ehjci\/jead140\/50717249\/jead140.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/24\/12\/1608\/53711232\/jead140.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/24\/12\/1608\/53711232\/jead140.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T22:56:39Z","timestamp":1700780199000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/24\/12\/1608\/7198021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,14]]},"references-count":34,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,6,14]]},"published-print":{"date-parts":[[2023,11,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jead140","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,12]]},"published":{"date-parts":[[2023,6,14]]}}}