{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:11:18Z","timestamp":1777515078256,"version":"3.51.4"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>\n              In aortic stenosis, valvulo-arterial impedance (Zva) estimates the overall left ventricular afterload (valve and arterial component). We investigated the association of Zva (\u22655 versus &lt;5 mm\u2009Hg mL\n              <jats:sup>\u22121<\/jats:sup>\n              m\n              <jats:sup>\u22122<\/jats:sup>\n              ) on quality of life (QOL) and exercise performance (EP) \u22651 year after transcatheter aortic valve replacement (TAVR).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The study population consists of 250 TAVR patients in whom baseline Zva and follow-up QOL was prospectively assessed using EuroQOL-5-dimensions instruments; EP was assessed in 192 patients who survived \u22651 year after TAVR using questionnaires related to daily activities. In 124 patients, Zva at 1-year was also available and was used to study the change in Zva (baseline to 1 year) on QOL\/EP.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Elevated baseline Zva was present in 125 patients (50%). At a median of 28 (IQR, 17\u201340) months, patients with elevated baseline Zva were more limited in mobility (88% versus 71%;\n              <jats:italic>P<\/jats:italic>\n              =0.004), self-care (40% versus 25%;\n              <jats:italic>P<\/jats:italic>\n              =0.019), and independent daily activities (taking a shower: 53% versus 38%,\n              <jats:italic>P<\/jats:italic>\n              =0.030; walking 100 meter: 76% versus 54%,\n              <jats:italic>P<\/jats:italic>\n              =0.001; and walking stairs: 74% versus 54%,\n              <jats:italic>P<\/jats:italic>\n              =0.011). By multivariable analysis, elevated Zva predicted unfavorable QOL (lower EuroQOL-5-dimensions-Utility Index, odds ratio, 1.98; CI, 1.15\u20133.41) and unfavorable EP (any limitation in \u22653 daily activities, odds ratio, 2.55; CI, 1.41\u20134.62). After TAVR, the proportion of patients with elevated Zva fell from 50% to 21% and remained 21% at 1 year and was found to be associated with more limitations in mobility, self-care, and daily activities compared with patients with Zva &lt;5 mm\u2009Hg mL\n              <jats:sup>\u22121<\/jats:sup>\n              m\n              <jats:sup>\u22122<\/jats:sup>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Elevated Zva was seen in half of patients and predicted unfavorable long-term QOL and EP. At 1 year after TAVR, the prevalence of elevated Zva was 21% but remained associated with poor QOL\/EP.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.119.008372","type":"journal-article","created":{"date-parts":[[2020,1,15]],"date-time":"2020-01-15T10:00:39Z","timestamp":1579082439000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Impact of Valvulo-Arterial Impedance on Long-Term Quality of Life and Exercise Performance After Transcatheter Aortic Valve Replacement"],"prefix":"10.1161","volume":"13","author":[{"given":"Rutger-Jan","family":"Nuis","sequence":"first","affiliation":[{"name":"Department of Cardiology (R.-J.N., M.J.A.G.d.R.T., H.K., J.F.O., M.P.v.W., M.L.G., F.Z., J.D., N.M.V.M., M.J.L., P.P.T.d.J.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannette A.","family":"Goudzwaard","sequence":"additional","affiliation":[{"name":"Section of Geriatrics, Department of Internal Medicine (J.A.G., F.U.S.M.-R.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjo J.A.G.","family":"de Ronde-Tillmans","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.-J.N., M.J.A.G.d.R.T., H.K., J.F.O., M.P.v.W., M.L.G., F.Z., J.D., N.M.V.M., M.J.L., P.P.T.d.J.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert","family":"Kroon","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.-J.N., M.J.A.G.d.R.T., H.K., J.F.O., M.P.v.W., M.L.G., F.Z., J.D., N.M.V.M., M.J.L., P.P.T.d.J.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joris F.","family":"Ooms","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.-J.N., M.J.A.G.d.R.T., H.K., J.F.O., M.P.v.W., M.L.G., F.Z., J.D., N.M.V.M., M.J.L., P.P.T.d.J.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten P.","family":"van Wiechen","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.-J.N., M.J.A.G.d.R.T., H.K., J.F.O., M.P.v.W., M.L.G., F.Z., J.D., N.M.V.M., M.J.L., P.P.T.d.J.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel L.","family":"Geleijnse","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.-J.N., M.J.A.G.d.R.T., H.K., J.F.O., M.P.v.W., M.L.G., F.Z., J.D., N.M.V.M., M.J.L., P.P.T.d.J.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Zijlstra","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.-J.N., M.J.A.G.d.R.T., H.K., J.F.O., M.P.v.W., M.L.G., F.Z., J.D., N.M.V.M., M.J.L., P.P.T.d.J.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joost","family":"Daemen","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.-J.N., M.J.A.G.d.R.T., H.K., J.F.O., M.P.v.W., M.L.G., F.Z., J.D., N.M.V.M., M.J.L., P.P.T.d.J.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas M.","family":"Van Mieghem","sequence":"additional","affiliation":[{"name":"Department of Cardiology (R.-J.N., M.J.A.G.d.R.T., H.K., J.F.O., M.P.v.W., M.L.G., F.Z., J.D., N.M.V.M., M.J.L., P.P.T.d.J.), Erasmus MC, Rotterdam, the Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco U.S.","family":"Mattace-Raso","sequence":"additional","affiliation":[{"name":"Section of Geriatrics, Department of Internal Medicine (J.A.G., F.U.S.M.-R.), Erasmus MC, Rotterdam, the 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