Assessment of left ventricular function with tissue Doppler echocardiography and of B-type natriuretic peptide levels in patients undergoing transcatheter aortic valve implantation | Revista Portuguesa de Cardiologia (English edition)

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BNP: B-type natriuretic peptide; LV: left ventricular; TAVR: transcatheter aortic valve implantation." ] ] ] "textoCompleto" => "IntroductionDegenerative aortic stenosis (AS) is the most common valvulopathy in the Western world. Transcatheter aortic valve implantation (TAVI) is an alternative treatment modality for patients with severe symptomatic AS who are at high risk for conventional aortic valve replacement (AVR) or are considered inoperable.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>B-type natriuretic peptide (BNP) is a marker of high left ventricular (LV) filling pressures and high wall shear stress independently of etiology and a strong predictor of mortality in heart failure patients.The prognostic value of BNP has been previously shown in heart failure and severe AS.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> The present study aimed to examine changes in serum BNP levels over time after transcatheter aortic valve implantation (TAVI). In addition, we aimed to assess the relationship of BNP with LV systolic and diastolic function in patients undergoing TAVI.MethodsPatientsBetween 2013 and 2015, 55 patients with symptomatic severe AS (aortic valve area [AVA] <1 cm2 or aortic valve index <0.5 cm2/m2) were enrolled. All had been referred for TAVI because of high operative risk, and all patients whose BNP levels were measured at baseline and after the TAVI procedure were included in the study. Suitability for TAVI was carefully considered in all patients by a multidisciplinary team consisting of an interventional cardiologist, a cardiac surgeon, a cardiac anesthetist and the patient's primary cardiologist. Patients’ symptomatic status was determined at baseline and at follow-up, including New York Heart Association (NYHA) functional class. Serum BNP levels were measured using a fluorescent immunoassay (Triage BNP Test, Biosite Diagnostics, San Diego, CA) within 24 h prior to the procedure (defined as baseline levels), and at the third month control.Echocardiographic assessmentAll patients underwent echocardiographic assessment at baseline and after the TAVI procedure in accordance with the American Society of Echocardiography criteria. Measurements were obtained in parasternal long-axis, parasternal short-axis, apical 4-chamber and apical 5-chamber views with the patient in the left lateral position. LV diastolic dysfunction (LVDD) was determined according to the standard guidelines. Criteria for the classification of LVDD were as follows: impaired diastolic relaxation was defined as E/A ratio <1 and E-wave deceleration time (EDT) >240 ms; pseudonormal filling as E/A ratio of 1-1.5, EDT >240 ms and isovolumetric relaxation time (IVRT) <90 ms or ratio between pulmonary vein diastolic and systolic filling velocities (PVd/PVs) >1.5; and restrictive pattern as EDT <160 ms with E/A ratio >1 and IVRT <70 ms.For tissue Doppler imaging (TDI), mitral flow was acquired in apical 2- and 4-chamber views. The sample volume was placed at the junction of the mitral annulus and the LV septum and lateral, inferior and anterior walls and was maintained perpendicular to the axis of the wall. Systolic myocardial velocity (Sm) and early diastolic (Em) and late diastolic (Am) myocardial velocities were measured and the Em/Am ratio was calculated (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). The myocardial performance index (MPI) (Tei index) was obtained by dividing the sum of isovolumetric contraction time and IVRT by ejection time on TDI. All patients underwent transesophageal echocardiography to determine annulus size prior to the procedure.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Transcatheter aortic valve implantation procedureTAVI was performed with the Edwards SAPIEN valve (Edward LifeSciences, Irvine, CA), which consists of a trileaflet bioprosthetic bovine pericardial tissue valve, mounted and sutured in a balloon-expandable cobalt-chromium stent. Valve size was selected based on annulus size measured by transesophageal echocardiography and/or during balloon sizing. Valves were implanted in all patients through a transfemoral approach. Balloon predilatation was performed in all patients in order to decide valve size and to aid with valve implantation.Preprocedurally all patients were treated with aspirin (100 mg/day) and a 300 mg loading dose of clopidogrel. During the intervention, patients received weight-adjusted intravenous heparin with a target activated clotting time of 250-300 s for the duration of the operation. A percutaneous closure device (Prostar XL or ProGlide) was used in 37 cases (67.2%) and surgical cut-down in the remainder.Statistical analysisContinuous variables were expressed as means with standard deviation or medians with interquartile range, and categorical variables as proportions and percentages. The non-parametric Kolmogorov-Smirnov test and histograms were used to assess, statistically and graphically, the normality of distribution of continuous variables. Differences between groups were analyzed by a two-tailed Student's t test for independent samples (or Wilcoxon's non-parametric test when appropriate) for continuous variables. Correlations of variables were assessed using Pearson or Spearman's correlation analysis. A two-sided p-value <0.05 was considered to represent statistical significance. The statistical analysis was performed using SPSS 16 for Windows (SPSS Inc, Chicago, Illinois, USA).ResultsThe study population consisted of 55 patients referred for TAVI. Mean logistic EuroSCORE was 25.62±6.34%, mean Society of Thoracic Surgeons score was 10.19±3.14 and mean age was 79.9±7.8 years. The clinical characteristics of the study population are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The 30-day mortality rate was 1.8% (one patient within 48 h). One patient required a permanent pacemaker (1.8%) and no mortality was recorded after TAVI at follow-up. The clinical features and conventional echocardiographic and TDI characteristics of patients initially and at one year after TAVI are presented in <a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2 and 3</a>.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Statistically significant early decreases in peak aortic valve gradient and mean LVEF and AVA were noted, with significant increases in the latter two. Significant decreases in interventricular septal diameter and posterior wall diameter were observed in the post-TAVI period. The decrease in LV end-systolic diameter end-diastolic diameter after TAVI was non-significant, but the decrease in LV end-systolic diameter during follow-up was statistically significant. Statistically significant decreases in left atrial anteroposterior diameter and increases in LV end-diastolic volume were observed after TAVI, and there was a trend for lower LV end-systolic volume. Consequently, a significant increase in LV stroke volume index was observed in the post-TAVI period. Positive changes in pulmonary artery systolic pressure (PASP) and LV MPI were also noted. PASP and MPI decreased significantly after TAVI (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).All patients had some degree of LV diastolic dysfunction before the TAVI procedure, and significant improvements in diastolic function was observed after TAVI. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the degree of LV diastolic dysfunction before and after TAVI.LV lateral wall Sm and Em increased significantly after TAVI. There was no significant change in LV lateral wall Am, hence the lateral wall Em/Am ratio increased (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). There were statistically significant decreases in lateral wall IVRT and MPI after TAVI (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Septal wall systolic wave velocity increase was also statistically significant. Septal wall Am was not significantly altered after TAVI, whereas there was a statistically significant increase in septal wall Em. Moreover, an increase in both septal wall and lateral Sm was found after TAVI, and this correlated with an increase in LVEF (r=0.38, p=0.001). There was a significant improvement in septal wall MPI after the TAVI procedure. In additional, positive changes in septal wall E/e’ ratio were observed after TAVI (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).No association was found between serum BNP level and AVA (r=-0.254, p=0.06). However, a significant correlation was found between BNP level and LV ejection fraction (LVEF) (r=-0.44, p=0.001), PASP (r=0.27, p=0.04) and NYHA class (r=0.33, p=0.001). A statistically significant decrease was observed in BNP levels of all patients after TAVI (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). The correlation between BNP levels and degree of diastolic dysfunction before and after TAVI is demonstrated in <a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>. Multivariate linear regression analysis revealed that LVEF (p=0.003) was an independent predictor of BNP decrease (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).<elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia>DiscussionBrain-type natriuretic peptide (BNP) is synthesized within the ventricles (as well as in the brain, where it was first identified). BNP is initially produced as pre-proBNP, which is then cleaved to proBNP and finally to BNP. These hormones have vasodilatory and diuretic effects and are antagonists of the adrenergic and renin-angiotensin systems.Increased myocardial wall stress has been proposed as a stimulus for the release of natriuretic peptides in AS.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> The prognostic value of these peptides in heart failure is well known,<a class="elsevierStyleCrossRef" href="#bib0020">4</a> and is also becoming increasingly apparent in patients with valvular disease. In particular, in patients with AS, BNP levels are directly related to severity and symptomatology.<a class="elsevierStyleCrossRefs" href="#bib0025">5,6</a> In the present study, there was a strong association between NYHA class and serum BNP levels.Natriuretic peptide levels are related to disease severity in AS and have prognostic value, predicting early outcome<a class="elsevierStyleCrossRef" href="#bib0035">7</a> and long-term mortality from any cause following conventional AVR.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> Recently, BNP was found to be a predictor of 30-day outcome after TAVI.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> However, correlations between BNP level and mortality could not be analyzed in our study due to the limited number of patients. Moreover, BNP elevation is a predictor of low LVEF, as shown in a previous study.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> However, we can state that a decrease in BNP levels predicts increased LVEF after TAVI.BNP elevation is associated with higher grade diastolic dysfunction and higher PASP in patients with severe AS undergoing TAVI. This marker would be useful clinically if a rise in BNP precedes the currently recognized clinical signs. However, in our study BNP level had no association with severity of AS. Some reports indicate that BNP level is an independent predictor of cardiovascular death in patients with severe AS.<a class="elsevierStyleCrossRefs" href="#bib0055">11–13</a> Furthermore, preoperative N-terminal (NT)-proBNP level independently predicts symptom-free survival.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> On the other hand, Pfister et al.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> found no association between NT-proBNP and two-month mortality after transapical TAVI.Correlates found in our study were mostly symptoms and signs of heart failure, including NYHA class, depressed LVEF, and elevated PASP. Importantly, no relationship was found between BNP level and severity of AS. Moreover, our study revealed an increase in LVEF and improvement in diastolic function as well as decreased PASP and BNP levels in patients with severe AS after TAVI.Three important conclusions can be derived from these data. First of all, we found that BNP levels are closely linked with findings of heart failure and degree of diastolic dysfunction. Secondly, as in the study by Ben-Dor et al.,<a class="elsevierStyleCrossRef" href="#bib0050">10</a> there was no significant correlation between BNP level and AVA in our study, which included only severe AS patients. Other studies that included mild to severe AS patients did in fact correlate AS severity with higher BNP values.<a class="elsevierStyleCrossRefs" href="#bib0025">5,15</a> Thirdly, our study demonstrated improvements in all these parameters and NYHA class.Pfister et al.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> reported an increase in NT-proBNP levels three days after TAVI, and they were still elevated at three months compared with baseline. In contrast to this finding, we found a significant decrease in BNP levels three months after TAVI. This indicates that BNP levels may fall two months after TAVI. Additionally, Spargias et al.<a class="elsevierStyleCrossRef" href="#bib0080">16</a> reported an early reduction in NT-proBNP after transfemoral TAVI.In patients with AS, higher increases in annualized BNP were significantly associated with a higher rate of the composite endpoint of occurrence of symptoms, AVR, or cardiovascular death.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> An increase in BNP of >20 pg/ml per year was associated with worse outcomes, even after adjustment for age and echocardiographic parameters. Therefore, follow-up measurement of serum BNP levels may be useful to predict adverse events in patients treated with TAVI.The majority of studies assessing the effect of TAVI on cardiac function have used classical echocardiographic parameters. These methods have some limitations, due to the fact that they are affected by changes in preload and afterload. In the literature, there is no study using TDI that managed to overcome these limitations to a significant extent. MPI is an independent marker of LV dysfunction that is independent of changes in heart rate and is valuable in the assessment of global LV function and the risk of developing heart failure.<a class="elsevierStyleCrossRef" href="#bib0090">18</a> In our study, LV Doppler measurements demonstrated a decrease in MPI after TAVI compared to baseline. On TDI, lateral and septal wall MPI was found to be significantly diminished after TAVI.Vogel et al.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> demonstrated a good correlation of LVEF with Sm during ventricular contraction and showed that it is affected by load. In our study, an increase was found in both septal wall and lateral Sm after TAVI, and this also correlated with an increase in LVEF. Moreover, an increase in lateral and septal Em by TAVI was evident, however there was no significant change in Am. Consequently, an increased Em/Am ratio was found in both lateral and septal walls.This study has some limitations. Our study is an observational, single-center registry of patients referred for TAVI. The sample size may be considered small. Moreover, the follow-up period was relatively short. In this narrow range of high-risk patients with advanced disease, the correlation between BNP and mortality is more difficult to establish; a larger sample size is needed to establish this correlation. Large randomized controlled trials could provide more definitive evidence in the future. The cohort included an elderly population with many comorbidities, which may have affected the other parameters.Our findings could have important implications in the clinical management and follow-up of these patients. Specifically, we recommend BNP follow-up after TAVI. Decreased serum BNP levels are associated with hemodynamic improvement in these patients. Thus, decreased BNP levels after TAVI may be associated with lower periprocedural and long-term risks.Our study demonstrated the existence of impairment in LV structure and diastolic function in AS patients and both conventional Doppler echocardiography, and TDI confirmed that this impairment can be reversed by TAVI.Ethical disclosuresProtection of human and animal subjectsThe authors declare that no experiments were performed on humans or animals for this study.Confidentiality of dataThe authors declare that they have followed the protocols of their work center on the publication of patient data.Right to privacy and informed consentThe authors declare that no patient data appear in this article.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres851874" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Aim" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec846484" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres851875" "titulo" => "Resumo" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introdução" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusão" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec846483" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Echocardiographic assessment" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Transcatheter aortic valve implantation procedure" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Discussion" ] 8 => array:3 [ "identificador" => "sec0045" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0050" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0055" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0060" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-02-29" "fechaAceptado" => "2016-10-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec846484" "palabras" => array:4 [ 0 => "B-type natriuretic peptide" 1 => "Left ventricular function" 2 => "Tissue Doppler echocardiography" 3 => "Transcatheter aortic valve implantation" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec846483" "palabras" => array:4 [ 0 => "Peptídeo natriurético tipo B" 1 => "Função ventricular esquerda" 2 => "Ecocardiografia por Doppler tecidular" 3 => "Implantação de válvula aórtica por via percutânea" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionTranscatheter aortic valve implantation (TAVI) is an emerging minimally invasive treatment modality in high surgical risk or inoperable patients. AimThe aim of this study was to ascertain the effect of TAVI on left ventricular (LV) systolic and diastolic function and serum B-type natriuretic peptide (BNP) levels in high surgical risk or inoperable patients with severe aortic stenosis. MethodsFifty-five patients were included in our retrospective study. LV systolic and diastolic function was assessed with conventional and tissue Doppler imaging (TDI) prior to and after TAVI. Additionally, BNP was measured 24 h before and three months after the procedure. Echocardiographic controls were performed at one, three and six months and one year and mean values were taken. At the end of the study, LV systolic and diastolic function, serum BNP levels and New York Heart Association functional capacity were assessed and compared to baseline parameters. ResultsThe TAVI procedure was successful in all patients. In-hospital mortality was 1.8% (one patient). There was a substantial improvement in LV function and functional capacity at follow-up. In addition, a statistically significant decrease was detected in serum BNP levels post-TAVI (median 380 pg/ml [176.6-929.3] vs. 215 pg/ml [96.0-383.0], p=0.0001). Only one patient required a permanent pacemaker (1.8%) and there was no mortality after TAVI during follow-up. There were significant increases in LV ejection fraction and aortic valve area (51.0±13.1% vs. 58.4±9.1%, p<0.001, and 0.6±0.1 cm2 vs. 2.1±0.2 cm2, p=0.0001, respectively). At the end of the study, conventional Doppler echocardiography revealed improvement in diastolic function, with an increase in mitral E wave, a decrease in mitral A wave and an increase in E/A ratio. Deceleration time and isovolumetric relaxation time were shortened and myocardial performance (Tei) index decreased. TDI showed an increase in systolic myocardial velocity (Sm) and early diastolic velocity (Em). Septal mitral annular Sm and Em were increased, whereas MPI was reduced. ConclusionWe found that LV structural changes and diastolic dysfunction occur in patients with severe aortic stenosis and that TAVI is able to reverse these abnormalities, which we demonstrated by both conventional echocardiography and TDI. In addition, serum BNP levels were decreased after TAVI." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Aim" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "IntroduçãoA implantação de válvula aórtica por via percutânea (VAP) é uma terapêutica minimamente invasiva e de uso crescente em doentes inoperáveis ou de alto risco cirúrgico. ObjetivoO objetivo deste estudo foi avaliar o efeito da implantação de VAP nas funções sistólica e diastólica do ventrículo esquerdo, e nos níveis plasmáticos do peptídeo natriurético tipo B (BNP), em doentes com estenose aórtica grave considerados inoperáveis ou de alto risco cirúrgico. MétodosEstudo restrospetivo em que foram incluídos 55 doentes. As funções sitólica e diastólica do ventrículo esquerdo foram determinadas por ecocardiografia Doppler convencional e tecidular, antes e após implantação de VAP. Os níveis de BNP foram medidos 24h antes e três meses após o procedimento. Foram efetuadas reavaliações ecocardiográficas aos um, três, seis e 12 meses. No final do estudo foram avaliadas as funções sitólica e diastólica do ventrículo esquerdo, os níveis plasmáticos do BNP e a classe funcional pela classificação da New York Heart Association (NYHA), e efetuada a comparação com os valores basais. ResultadosA VAP foi implantada com sucesso em todos os doentes. A mortalidade intra-hospitalar foi de 1,8% (n=1). Documentou-se uma melhoria substancial na função ventricular esquerda e da capacidade funcional no follow-up. Observou-se uma redução estatisticamente significativa dos níveis plasmáticos de BNP após VAP (mediana: 380 [176,6 – 929,3] pg/mL versus 215 [96,0 – 383,0] pg/mL, p=0,0001). Foi necessária a implantação de pacemaker permanente em apenas um doente (1,8%) e não houve mais mortes durante o follow-up. Observou-se um aumento significativo da fração de ejeção do ventrículo esquerdo (51,0±13,1% versus 58,4±9,1%, p<0,001) e da área valvular aórtica (0,6±0,1cm2versus 2,1±0,2cm2, p=0,0001). No final do estudo, observou-se uma melhoria dos parâmetros de função diastólica, com aumento da onda E mitral, diminuição da onda A mitral e aumento da relação E/A. Os tempos de desaceleração da onda E e o de relaxamento isovolumétrico encurtaram e o indíce de Tei diminuiu. Por ecocardiografia com Doppler tecidular observou-se um aumento da velocidade sistólica de deslocamento da parede lateral (Sm) e da velocidade da onda E’ (Em). Ocorreu igualmente um aumento das velocidades de deslocamento do anel mitral septal (Sm e Em) e uma redução do índice de Tei. ConclusãoOs doentes com estenose aórtica grave têm alterações estruturais do ventrículo esquerdo e disfunção diastólica. A implantação de VAP pode reverter estas alterações, conforme foi demonstrado neste estudo de ecocardiografia Doppler convencional e tecidular. Ocorreu ainda uma redução dos níveis plasmáticos de BNP após implantação de VAP." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introdução" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusão" ] ] ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1315 "Ancho" => 1647 "Tamanyo" => 65517 ] ] "descripcion" => array:1 [ "en" => "Serum B-type natriuretic peptide levels before and after transcatheter aortic valve implantation. BNP: B-type natriuretic peptide." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1430 "Ancho" => 3007 "Tamanyo" => 159199 ] ] "descripcion" => array:1 [ "en" => "The relationship between serum B-type natriuretic peptide levels and diastolic function before (A) and after (B) transcatheter aortic valve implantation. BNP: B-type natriuretic peptide; LV: left ventricular; TAVR: transcatheter aortic valve implantation." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Values are expressed as number (%) or mean ± standard deviation.AF: atrial fibrillation; BMI: body mass index; CABG: coronary artery bypass grafting; CAD: coronary artery disease; COPD: chronic obstructive pulmonary disease; CrCl: creatine clearance; NYHA: New York Heart Association; PAD: peripheral artery disease; PPI: permanent pacemaker implantation; STS: Society of Thoracic Surgeons." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78.9±7.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender (male/female), n \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21/34 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI (kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27.1±4.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">STS score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.19±3.14 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Logistic EuroSCORE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25.62±6.34 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">NYHA class IV, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 (21.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 (36.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Smoker, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (7.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Systemic hypertension, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34 (61.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CAD, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 (54.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PAD, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 (27.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">COPD, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50 (90.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (26) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Moderate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29 (58) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 (16) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Renal failure (CrCl <60 ml/min), n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17 (30.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous CABG, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (12.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous stroke, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 (10.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous PPI, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (3.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">AF, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (7.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1438189.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Baseline clinical characteristics of the study population." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Values are expressed as means ± SD or percentages unless otherwise indicated.AVA: aortic valve area; AVG: aortic valve gradient; BNP: brain-type natriuretic peptide; DT: deceleration time; IVRT: isovolumetric relaxation time; IVSD: interventricular septal diameter; LA: left atrial; LAd: left atrial anteroposterior diameter; LAVI: left atrial volume index; LV: left ventricular; LVEDD: left ventricular end-diastolic diameter; LVEF: left ventricular ejection fraction; LVESD: left ventricular end-systolic diameter; LVEDV: left ventricular end-diastolic volume; LVESV: left ventricular end-systolic volume; LVSV: left ventricular stroke volume; MPI: myocardial performance index; NS: not significant; NYHA: New York Heart Association; PASP: pulmonary artery systolic pressure; PWD: posterior wall diameter; TAVI: transcatheter aortic valve implantation." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Before TAVI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">After TAVI (1 death) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">NYHA class, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 (14.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (5.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">39 (72.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40 (72.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (9.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 (21.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (3.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peak AVG, mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">72.0±18.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.2±4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean AVG, mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51.0±15.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.2±2.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">AVA, cm2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.6±0.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.1±0.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVEF, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">51.0±13.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">58.4±9.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVEDD, mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">48.4±7.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">48.2±5.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVESD, mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33.8±9.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">31.5±6.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVEDV, ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">97.6±22.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">108.4±22.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVESV, ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37.6±10.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34.8±8.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVSV index, ml/m2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61.7±16.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">74.0±16.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IVSD, mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14.4±1.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.1±1.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PWD, mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.6±1.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.7±1.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LAd, mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29.1±2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27.0±2.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PASP, mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">49.1±18.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34.6±11.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV MPI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.47±0.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.43±0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.03 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">E wave, m/s \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.55±0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.75±0.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">A wave, m/s \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.75±0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.54±0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">E/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.71±0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.36±0.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DT, ms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">237.7±20.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">196.9±18.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IVRT, ms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">119.5±7.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100.3±8.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Normal LV diastolic function, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17 (30.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Grade 1 LV diastolic dysfunction, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26 (47.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 (63.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Grade 2 LV diastolic dysfunction, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17 (30.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (3.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Grade 3 LV diastolic dysfunction, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 (21.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (1.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1438192.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Clinical features and conventional echocardiographic measurements before and after TAVI." ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Values are expressed as means ± standard deviation or means (range).Am: late diastolic myocardial velocity; Em: early diastolic myocardial velocity; IVRT: isovolumetric relaxation time; lat: lateral; LV: left ventricular; MPI: myocardial performance index; NS: not significant; sep: septal; Sm: systolic myocardial velocity." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Before TAVI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">After TAVI (3rd month) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat Sm (cm/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.0 (7.0-8.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9.0 (8.0-10.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat Em (cm/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9.0 (7.0-12.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.7 (9.7-15.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat Am (cm/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.8±2.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.1±2.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat Em/Am \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.83 (0.60-1.26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.20 (0.91-1.36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat IVRT (ms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">99.3±19.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">85.7±13.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat MPI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.677±0.025 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.614±0.020 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep Sm (cm/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.5 (7.0-9.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.0 (8.0-9.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.007 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep Em (cm/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.0 (6.0-9.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9.0 (7.0-13.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep Am (cm/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.0 (9.0-11.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.0 (8.0-10.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep Em/Am \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.80 (0.62-1.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.05 (0.80-1.30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep IVRT (ms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">97.0 (80.0-107.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">83.0 (75.5-98.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep MPI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.696±0.026 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.604±0.024 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Septal E/e’ ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.09±1.60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.69±1.55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lateral E/e’ ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.67±1.46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14.72±1.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean E/e’ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.37±1.52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14.20±1.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1438190.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Baseline and follow-up tissue Doppler imaging assessments of left ventricular lateral and septal wall." ] ] 5 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "BMI: body mass index; CKD: chronic kidney disease; LVEF: left ventricular ejection fraction; STS: Society of Thoracic Surgeons." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Risk ratio \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% confidence interval \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-13.328 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-37.064 to 10.407 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.267 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-26.256 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-395.962 to 343.450 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.888 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LVEF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-20.216 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-33.493 to -6.938 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">STS score \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38.313 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-23.225 to 99.852 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.219 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">154.284 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-181.576 to 490.144 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.363 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CKD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-207.396 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-570.517 to 155.724 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.259 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-11.045 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-54.216 to 32.126 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.612 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobin level \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-39.866 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">-134.831 to 55.099 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.405 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1438191.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Multivariate linear regression analysis demonstrating predictors of falls in B-type natriuretic peptide levels in patients undergoing transcatheter aortic valve implantation." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Vahanian" 1 => "O. Alfieri" 2 => "N. Al-Attar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehn183" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2008" "volumen" => "29" "paginaInicial" => "1463" "paginaFinal" => "1470" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18474941" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Heart failure in patients with aortic stenosis: clinical and prognostic significance of carbohydrate antigen 125 and brain natriuretic peptide measurement" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "F. Antonini-Canterin" 1 => "B.A. Popescu" 2 => "A.C. Popescu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijcard.2007.05.039" "Revista" => array:6 [ "tituloSerie" => "Int J Cardiol" "fecha" => "2008" "volumen" => "128" "paginaInicial" => "406" "paginaFinal" => "412" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17662495" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Plasma levels of brain and atrial natriuretic peptides elevate in proportion to left ventricular end-systolic wall stress in patients with aortic stenosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "T. Ikeda" 1 => "K. Matsuda" 2 => "H. Itoh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am Heart J" "fecha" => "1997" "volumen" => "133" "paginaInicial" => "307" "paginaFinal" => "314" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9060799" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. Rev Esp Cardiol (Engl Ed). 2016; 69:1167." ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relation of N-terminal pro-B-type natriuretic peptide to severity of valvular aortic stenosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Weber" 1 => "R. Arnold" 2 => "M. Rau" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjcard.2004.05.055" "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol" "fecha" => "2004" "volumen" => "94" "paginaInicial" => "740" "paginaFinal" => "745" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15374777" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased plasma natriuretic peptide levels reflect symptoms onset in aortic stenosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "I.L. Gerber" 1 => "R.A. Stewart" 2 => "M.E. Legget" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.CIR.0000060533.79248.0C" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2003" "volumen" => "107" "paginaInicial" => "1884" "paginaFinal" => "1890" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12668523" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natriuretic peptides predict symptom-free survival and postoperative outcome in severe aortic stenosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Bergler-Klein" 1 => "U. Klaar" 2 => "M. 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Monchi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ehj.2004.09.033" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2004" "volumen" => "25" "paginaInicial" => "2048" "paginaFinal" => "2053" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15541842" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Usefulness of an elevated B-type natriuretic peptide in predicting survival in patients with aortic stenosis treated without surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.G. Nessmith" 1 => "H. Fukuta" 2 => "S. Brucks" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjcard.2005.06.092" "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol" "fecha" => "2005" "volumen" => "96" "paginaInicial" => "1445" "paginaFinal" => "1448" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16275196" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natriuretic peptides and long-term mortality in patients with severe aortic stenosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Katz" 1 => "F. Tarasoutchi" 2 => "A.E. 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Baer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00392-010-0118-x" "Revista" => array:6 [ "tituloSerie" => "Clin Res Cardiol" "fecha" => "2010" "volumen" => "99" "paginaInicial" => "301" "paginaFinal" => "307" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20140438" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relation of N-terminal pro-B-type natriuretic peptide to progression of aortic valve disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Weber" 1 => "R. Arnold" 2 => "M. 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Original Article

Assessment of left ventricular function with tissue Doppler echocardiography and of B-type natriuretic peptide levels in patients undergoing transcatheter aortic valve implantation

Avaliação da função ventricular esquerda por ecocardiografia com Doppler tecidular e avaliação dos níveis de peptídeo natriurético tipo B, em doentes submetidos a implantação de válvula aórtica percutânea

Isa Oner Yüksela,

Corresponding author

drisayuksel2@hotmail.com

Corresponding author.

, Sakir Arslana, Goksel Cagircia, Erkan Koklua, Cagin M. Ureyena, Nermin Bayara, Selcuk Kucukseymena, Gorkem Kusa, Ramazan Guvenb

a University of Health Sciences, Antalya Education and Research Hospital, Department of Cardiology, Antalya, Turkey

b Mus State Hospital, Department of Emergency Medicine, Antalya, Turkey

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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The relationship between serum B-type natriuretic peptide levels and diastolic function before &#40;A&#41; and after &#40;B&#41; transcatheter aortic valve implantation&#46; BNP&#58; B-type natriuretic peptide&#59; LV&#58; left ventricular&#59; TAVR&#58; transcatheter aortic valve implantation&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Degenerative aortic stenosis &#40;AS&#41; is the most common valvulopathy in the Western world&#46; Transcatheter aortic valve implantation &#40;TAVI&#41; is an alternative treatment modality for patients with severe symptomatic AS who are at high risk for conventional aortic valve replacement &#40;AVR&#41; or are considered inoperable&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">B-type natriuretic peptide &#40;BNP&#41; is a marker of high left ventricular &#40;LV&#41; filling pressures and high wall shear stress independently of etiology and a strong predictor of mortality in heart failure patients&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The prognostic value of BNP has been previously shown in heart failure and severe AS&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The present study aimed to examine changes in serum BNP levels over time after transcatheter aortic valve implantation &#40;TAVI&#41;&#46; In addition&#44; we aimed to assess the relationship of BNP with LV systolic and diastolic function in patients undergoing TAVI&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Patients</span><p id="par0020" class="elsevierStylePara elsevierViewall">Between 2013 and 2015&#44; 55 patients with symptomatic severe AS &#40;aortic valve area &#91;AVA&#93; &#60;1 cm<span class="elsevierStyleSup">2</span> or aortic valve index &#60;0&#46;5 cm<span class="elsevierStyleSup">2</span>&#47;m<span class="elsevierStyleSup">2</span>&#41; were enrolled&#46; All had been referred for TAVI because of high operative risk&#44; and all patients whose BNP levels were measured at baseline and after the TAVI procedure were included in the study&#46; Suitability for TAVI was carefully considered in all patients by a multidisciplinary team consisting of an interventional cardiologist&#44; a cardiac surgeon&#44; a cardiac anesthetist and the patient&#39;s primary cardiologist&#46; Patients&#8217; symptomatic status was determined at baseline and at follow-up&#44; including New York Heart Association &#40;NYHA&#41; functional class&#46; Serum BNP levels were measured using a fluorescent immunoassay &#40;Triage BNP Test&#44; Biosite Diagnostics&#44; San Diego&#44; CA&#41; within 24 h prior to the procedure &#40;defined as baseline levels&#41;&#44; and at the third month control&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Echocardiographic assessment</span><p id="par0025" class="elsevierStylePara elsevierViewall">All patients underwent echocardiographic assessment at baseline and after the TAVI procedure in accordance with the American Society of Echocardiography criteria&#46; Measurements were obtained in parasternal long-axis&#44; parasternal short-axis&#44; apical 4-chamber and apical 5-chamber views with the patient in the left lateral position&#46; LV diastolic dysfunction &#40;LVDD&#41; was determined according to the standard guidelines&#46; Criteria for the classification of LVDD were as follows&#58; impaired diastolic relaxation was defined as E&#47;A ratio &#60;1 and E-wave deceleration time &#40;EDT&#41; &#62;240 ms&#59; pseudonormal filling as E&#47;A ratio of 1-1&#46;5&#44; EDT &#62;240 ms and isovolumetric relaxation time &#40;IVRT&#41; &#60;90 ms or ratio between pulmonary vein diastolic and systolic filling velocities &#40;PVd&#47;PVs&#41; &#62;1&#46;5&#59; and restrictive pattern as EDT &#60;160 ms with E&#47;A ratio &#62;1 and IVRT &#60;70 ms&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">For tissue Doppler imaging &#40;TDI&#41;&#44; mitral flow was acquired in apical 2- and 4-chamber views&#46; The sample volume was placed at the junction of the mitral annulus and the LV septum and lateral&#44; inferior and anterior walls and was maintained perpendicular to the axis of the wall&#46; Systolic myocardial velocity &#40;Sm&#41; and early diastolic &#40;Em&#41; and late diastolic &#40;Am&#41; myocardial velocities were measured and the Em&#47;Am ratio was calculated &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; The myocardial performance index &#40;MPI&#41; &#40;Tei index&#41; was obtained by dividing the sum of isovolumetric contraction time and IVRT by ejection time on TDI&#46; All patients underwent transesophageal echocardiography to determine annulus size prior to the procedure&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Transcatheter aortic valve implantation procedure</span><p id="par0035" class="elsevierStylePara elsevierViewall">TAVI was performed with the Edwards SAPIEN valve &#40;Edward LifeSciences&#44; Irvine&#44; CA&#41;&#44; which consists of a trileaflet bioprosthetic bovine pericardial tissue valve&#44; mounted and sutured in a balloon-expandable cobalt-chromium stent&#46; Valve size was selected based on annulus size measured by transesophageal echocardiography and&#47;or during balloon sizing&#46; Valves were implanted in all patients through a transfemoral approach&#46; Balloon predilatation was performed in all patients in order to decide valve size and to aid with valve implantation&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Preprocedurally all patients were treated with aspirin &#40;100 mg&#47;day&#41; and a 300 mg loading dose of clopidogrel&#46; During the intervention&#44; patients received weight-adjusted intravenous heparin with a target activated clotting time of 250-300 s for the duration of the operation&#46; A percutaneous closure device &#40;Prostar XL or ProGlide&#41; was used in 37 cases &#40;67&#46;2&#37;&#41; and surgical cut-down in the remainder&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">Continuous variables were expressed as means with standard deviation or medians with interquartile range&#44; and categorical variables as proportions and percentages&#46; The non-parametric Kolmogorov-Smirnov test and histograms were used to assess&#44; statistically and graphically&#44; the normality of distribution of continuous variables&#46; Differences between groups were analyzed by a two-tailed Student&#39;s t test for independent samples &#40;or Wilcoxon&#39;s non-parametric test when appropriate&#41; for continuous variables&#46; Correlations of variables were assessed using Pearson or Spearman&#39;s correlation analysis&#46; A two-sided p-value &#60;0&#46;05 was considered to represent statistical significance&#46; The statistical analysis was performed using SPSS 16 for Windows &#40;SPSS Inc&#44; Chicago&#44; Illinois&#44; USA&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">The study population consisted of 55 patients referred for TAVI&#46; Mean logistic EuroSCORE was 25&#46;62&#177;6&#46;34&#37;&#44; mean Society of Thoracic Surgeons score was 10&#46;19&#177;3&#46;14 and mean age was 79&#46;9&#177;7&#46;8 years&#46; The clinical characteristics of the study population are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The 30-day mortality rate was 1&#46;8&#37; &#40;one patient within 48 h&#41;&#46; One patient required a permanent pacemaker &#40;1&#46;8&#37;&#41; and no mortality was recorded after TAVI at follow-up&#46; The clinical features and conventional echocardiographic and TDI characteristics of patients initially and at one year after TAVI are presented in <a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2 and 3</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Statistically significant early decreases in peak aortic valve gradient and mean LVEF and AVA were noted&#44; with significant increases in the latter two&#46; Significant decreases in interventricular septal diameter and posterior wall diameter were observed in the post-TAVI period&#46; The decrease in LV end-systolic diameter end-diastolic diameter after TAVI was non-significant&#44; but the decrease in LV end-systolic diameter during follow-up was statistically significant&#46; Statistically significant decreases in left atrial anteroposterior diameter and increases in LV end-diastolic volume were observed after TAVI&#44; and there was a trend for lower LV end-systolic volume&#46; Consequently&#44; a significant increase in LV stroke volume index was observed in the post-TAVI period&#46; Positive changes in pulmonary artery systolic pressure &#40;PASP&#41; and LV MPI were also noted&#46; PASP and MPI decreased significantly after TAVI &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">All patients had some degree of LV diastolic dysfunction before the TAVI procedure&#44; and significant improvements in diastolic function was observed after TAVI&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the degree of LV diastolic dysfunction before and after TAVI&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">LV lateral wall Sm and Em increased significantly after TAVI&#46; There was no significant change in LV lateral wall Am&#44; hence the lateral wall Em&#47;Am ratio increased &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; There were statistically significant decreases in lateral wall IVRT and MPI after TAVI &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Septal wall systolic wave velocity increase was also statistically significant&#46; Septal wall Am was not significantly altered after TAVI&#44; whereas there was a statistically significant increase in septal wall Em&#46; Moreover&#44; an increase in both septal wall and lateral Sm was found after TAVI&#44; and this correlated with an increase in LVEF &#40;r&#61;0&#46;38&#44; p&#61;0&#46;001&#41;&#46; There was a significant improvement in septal wall MPI after the TAVI procedure&#46; In additional&#44; positive changes in septal wall E&#47;e&#8217; ratio were observed after TAVI &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">No association was found between serum BNP level and AVA &#40;r&#61;-0&#46;254&#44; p&#61;0&#46;06&#41;&#46; However&#44; a significant correlation was found between BNP level and LV ejection fraction &#40;LVEF&#41; &#40;r&#61;-0&#46;44&#44; p&#61;0&#46;001&#41;&#44; PASP &#40;r&#61;0&#46;27&#44; p&#61;0&#46;04&#41; and NYHA class &#40;r&#61;0&#46;33&#44; p&#61;0&#46;001&#41;&#46; A statistically significant decrease was observed in BNP levels of all patients after TAVI &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; The correlation between BNP levels and degree of diastolic dysfunction before and after TAVI is demonstrated in <a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#46; Multivariate linear regression analysis revealed that LVEF &#40;p&#61;0&#46;003&#41; was an independent predictor of BNP decrease &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Brain-type natriuretic peptide &#40;BNP&#41; is synthesized within the ventricles &#40;as well as in the brain&#44; where it was first identified&#41;&#46; BNP is initially produced as pre-proBNP&#44; which is then cleaved to proBNP and finally to BNP&#46; These hormones have vasodilatory and diuretic effects and are antagonists of the adrenergic and renin-angiotensin systems&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Increased myocardial wall stress has been proposed as a stimulus for the release of natriuretic peptides in AS&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The prognostic value of these peptides in heart failure is well known&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and is also becoming increasingly apparent in patients with valvular disease&#46; In particular&#44; in patients with AS&#44; BNP levels are directly related to severity and symptomatology&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> In the present study&#44; there was a strong association between NYHA class and serum BNP levels&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Natriuretic peptide levels are related to disease severity in AS and have prognostic value&#44; predicting early outcome<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and long-term mortality from any cause following conventional AVR&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Recently&#44; BNP was found to be a predictor of 30-day outcome after TAVI&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> However&#44; correlations between BNP level and mortality could not be analyzed in our study due to the limited number of patients&#46; Moreover&#44; BNP elevation is a predictor of low LVEF&#44; as shown in a previous study&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> However&#44; we can state that a decrease in BNP levels predicts increased LVEF after TAVI&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">BNP elevation is associated with higher grade diastolic dysfunction and higher PASP in patients with severe AS undergoing TAVI&#46; This marker would be useful clinically if a rise in BNP precedes the currently recognized clinical signs&#46; However&#44; in our study BNP level had no association with severity of AS&#46; Some reports indicate that BNP level is an independent predictor of cardiovascular death in patients with severe AS&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#8211;13</span></a> Furthermore&#44; preoperative N-terminal &#40;NT&#41;-proBNP level independently predicts symptom-free survival&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> On the other hand&#44; Pfister et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> found no association between NT-proBNP and two-month mortality after transapical TAVI&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Correlates found in our study were mostly symptoms and signs of heart failure&#44; including NYHA class&#44; depressed LVEF&#44; and elevated PASP&#46; Importantly&#44; no relationship was found between BNP level and severity of AS&#46; Moreover&#44; our study revealed an increase in LVEF and improvement in diastolic function as well as decreased PASP and BNP levels in patients with severe AS after TAVI&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Three important conclusions can be derived from these data&#46; First of all&#44; we found that BNP levels are closely linked with findings of heart failure and degree of diastolic dysfunction&#46; Secondly&#44; as in the study by Ben-Dor et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> there was no significant correlation between BNP level and AVA in our study&#44; which included only severe AS patients&#46; Other studies that included mild to severe AS patients did in fact correlate AS severity with higher BNP values&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;15</span></a> Thirdly&#44; our study demonstrated improvements in all these parameters and NYHA class&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Pfister et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> reported an increase in NT-proBNP levels three days after TAVI&#44; and they were still elevated at three months compared with baseline&#46; In contrast to this finding&#44; we found a significant decrease in BNP levels three months after TAVI&#46; This indicates that BNP levels may fall two months after TAVI&#46; Additionally&#44; Spargias et al&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> reported an early reduction in NT-proBNP after transfemoral TAVI&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In patients with AS&#44; higher increases in annualized BNP were significantly associated with a higher rate of the composite endpoint of occurrence of symptoms&#44; AVR&#44; or cardiovascular death&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> An increase in BNP of &#62;20 pg&#47;ml per year was associated with worse outcomes&#44; even after adjustment for age and echocardiographic parameters&#46; Therefore&#44; follow-up measurement of serum BNP levels may be useful to predict adverse events in patients treated with TAVI&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The majority of studies assessing the effect of TAVI on cardiac function have used classical echocardiographic parameters&#46; These methods have some limitations&#44; due to the fact that they are affected by changes in preload and afterload&#46; In the literature&#44; there is no study using TDI that managed to overcome these limitations to a significant extent&#46; MPI is an independent marker of LV dysfunction that is independent of changes in heart rate and is valuable in the assessment of global LV function and the risk of developing heart failure&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> In our study&#44; LV Doppler measurements demonstrated a decrease in MPI after TAVI compared to baseline&#46; On TDI&#44; lateral and septal wall MPI was found to be significantly diminished after TAVI&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Vogel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> demonstrated a good correlation of LVEF with Sm during ventricular contraction and showed that it is affected by load&#46; In our study&#44; an increase was found in both septal wall and lateral Sm after TAVI&#44; and this also correlated with an increase in LVEF&#46; Moreover&#44; an increase in lateral and septal Em by TAVI was evident&#44; however there was no significant change in Am&#46; Consequently&#44; an increased Em&#47;Am ratio was found in both lateral and septal walls&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">This study has some limitations&#46; Our study is an observational&#44; single-center registry of patients referred for TAVI&#46; The sample size may be considered small&#46; Moreover&#44; the follow-up period was relatively short&#46; In this narrow range of high-risk patients with advanced disease&#44; the correlation between BNP and mortality is more difficult to establish&#59; a larger sample size is needed to establish this correlation&#46; Large randomized controlled trials could provide more definitive evidence in the future&#46; The cohort included an elderly population with many comorbidities&#44; which may have affected the other parameters&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Our findings could have important implications in the clinical management and follow-up of these patients&#46; Specifically&#44; we recommend BNP follow-up after TAVI&#46; Decreased serum BNP levels are associated with hemodynamic improvement in these patients&#46; Thus&#44; decreased BNP levels after TAVI may be associated with lower periprocedural and long-term risks&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Our study demonstrated the existence of impairment in LV structure and diastolic function in AS patients and both conventional Doppler echocardiography&#44; and TDI confirmed that this impairment can be reversed by TAVI&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Ethical disclosures</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Protection of human and animal subjects</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Confidentiality of data</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Right to privacy and informed consent</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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            2 => "Ecocardiografia por Doppler tecidular"
            3 => "Implanta&#231;&#227;o de v&#225;lvula a&#243;rtica por via percut&#226;nea"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transcatheter aortic valve implantation &#40;TAVI&#41; is an emerging minimally invasive treatment modality in high surgical risk or inoperable patients&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Aim</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to ascertain the effect of TAVI on left ventricular &#40;LV&#41; systolic and diastolic function and serum B-type natriuretic peptide &#40;BNP&#41; levels in high surgical risk or inoperable patients with severe aortic stenosis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Fifty-five patients were included in our retrospective study&#46; LV systolic and diastolic function was assessed with conventional and tissue Doppler imaging &#40;TDI&#41; prior to and after TAVI&#46; Additionally&#44; BNP was measured 24 h before and three months after the procedure&#46; Echocardiographic controls were performed at one&#44; three and six months and one year and mean values were taken&#46; At the end of the study&#44; LV systolic and diastolic function&#44; serum BNP levels and New York Heart Association functional capacity were assessed and compared to baseline parameters&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The TAVI procedure was successful in all patients&#46; In-hospital mortality was 1&#46;8&#37; &#40;one patient&#41;&#46; There was a substantial improvement in LV function and functional capacity at follow-up&#46; In addition&#44; a statistically significant decrease was detected in serum BNP levels post-TAVI &#40;median 380 pg&#47;ml &#91;176&#46;6-929&#46;3&#93; vs&#46; 215 pg&#47;ml &#91;96&#46;0-383&#46;0&#93;&#44; p&#61;0&#46;0001&#41;&#46; Only one patient required a permanent pacemaker &#40;1&#46;8&#37;&#41; and there was no mortality after TAVI during follow-up&#46; There were significant increases in LV ejection fraction and aortic valve area &#40;51&#46;0&#177;13&#46;1&#37; vs&#46; 58&#46;4&#177;9&#46;1&#37;&#44; p&#60;0&#46;001&#44; and 0&#46;6&#177;0&#46;1 cm<span class="elsevierStyleSup">2</span> vs&#46; 2&#46;1&#177;0&#46;2 cm<span class="elsevierStyleSup">2</span>&#44; p&#61;0&#46;0001&#44; respectively&#41;&#46; At the end of the study&#44; conventional Doppler echocardiography revealed improvement in diastolic function&#44; with an increase in mitral E wave&#44; a decrease in mitral A wave and an increase in E&#47;A ratio&#46; Deceleration time and isovolumetric relaxation time were shortened and myocardial performance &#40;Tei&#41; index decreased&#46; TDI showed an increase in systolic myocardial velocity &#40;Sm&#41; and early diastolic velocity &#40;Em&#41;&#46; Septal mitral annular Sm and Em were increased&#44; whereas MPI was reduced&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We found that LV structural changes and diastolic dysfunction occur in patients with severe aortic stenosis and that TAVI is able to reverse these abnormalities&#44; which we demonstrated by both conventional echocardiography and TDI&#46; In addition&#44; serum BNP levels were decreased after TAVI&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introdu&#231;&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A implanta&#231;&#227;o de v&#225;lvula a&#243;rtica por via percut&#226;nea &#40;VAP&#41; &#233; uma terap&#234;utica minimamente invasiva e de uso crescente em doentes inoper&#225;veis ou de alto risco cir&#250;rgico&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">O objetivo deste estudo foi avaliar o efeito da implanta&#231;&#227;o de VAP nas fun&#231;&#245;es sist&#243;lica e diast&#243;lica do ventr&#237;culo esquerdo&#44; e nos n&#237;veis plasm&#225;ticos do pept&#237;deo natriur&#233;tico tipo B &#40;BNP&#41;&#44; em doentes com estenose a&#243;rtica grave considerados inoper&#225;veis ou de alto risco cir&#250;rgico&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Estudo restrospetivo em que foram inclu&#237;dos 55 doentes&#46; As fun&#231;&#245;es sit&#243;lica e diast&#243;lica do ventr&#237;culo esquerdo foram determinadas por ecocardiografia Doppler convencional e tecidular&#44; antes e ap&#243;s implanta&#231;&#227;o de VAP&#46; Os n&#237;veis de BNP foram medidos 24<span class="elsevierStyleHsp" style=""></span>h antes e tr&#234;s meses ap&#243;s o procedimento&#46; Foram efetuadas reavalia&#231;&#245;es ecocardiogr&#225;ficas aos um&#44; tr&#234;s&#44; seis e 12 meses&#46; No final do estudo foram avaliadas as fun&#231;&#245;es sit&#243;lica e diast&#243;lica do ventr&#237;culo esquerdo&#44; os n&#237;veis plasm&#225;ticos do BNP e a classe funcional pela classifica&#231;&#227;o da <span class="elsevierStyleItalic">New York Heart Association</span> &#40;NYHA&#41;&#44; e efetuada a compara&#231;&#227;o com os valores basais&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A VAP foi implantada com sucesso em todos os doentes&#46; A mortalidade intra-hospitalar foi de 1&#44;8&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46; Documentou-se uma melhoria substancial na fun&#231;&#227;o ventricular esquerda e da capacidade funcional no <span class="elsevierStyleItalic">follow-up</span>&#46; Observou-se uma redu&#231;&#227;o estatisticamente significativa dos n&#237;veis plasm&#225;ticos de BNP ap&#243;s VAP &#40;mediana&#58; 380 &#91;176&#44;6 &#8211; 929&#44;3&#93; pg&#47;mL <span class="elsevierStyleItalic">versus</span> 215 &#91;96&#44;0 &#8211; 383&#44;0&#93; pg&#47;mL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; Foi necess&#225;ria a implanta&#231;&#227;o de <span class="elsevierStyleItalic">pacemaker</span> permanente em apenas um doente &#40;1&#44;8&#37;&#41; e n&#227;o houve mais mortes durante o <span class="elsevierStyleItalic">follow-up</span>&#46; Observou-se um aumento significativo da fra&#231;&#227;o de eje&#231;&#227;o do ventr&#237;culo esquerdo &#40;51&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;1&#37; <span class="elsevierStyleItalic">versus</span> 58&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;1&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e da &#225;rea valvular a&#243;rtica &#40;0&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">2</span><span class="elsevierStyleItalic">versus</span> 2&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">2</span>&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46; No final do estudo&#44; observou-se uma melhoria dos par&#226;metros de fun&#231;&#227;o diast&#243;lica&#44; com aumento da onda E mitral&#44; diminui&#231;&#227;o da onda A mitral e aumento da rela&#231;&#227;o E&#47;A&#46; Os tempos de desacelera&#231;&#227;o da onda E e o de relaxamento isovolum&#233;trico encurtaram e o ind&#237;ce de Tei diminuiu&#46; Por ecocardiografia com Doppler tecidular observou-se um aumento da velocidade sist&#243;lica de deslocamento da parede lateral &#40;Sm&#41; e da velocidade da onda E&#8217; &#40;Em&#41;&#46; Ocorreu igualmente um aumento das velocidades de deslocamento do anel mitral septal &#40;Sm e Em&#41; e uma redu&#231;&#227;o do &#237;ndice de Tei&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclus&#227;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Os doentes com estenose a&#243;rtica grave t&#234;m altera&#231;&#245;es estruturais do ventr&#237;culo esquerdo e disfun&#231;&#227;o diast&#243;lica&#46; A implanta&#231;&#227;o de VAP pode reverter estas altera&#231;&#245;es&#44; conforme foi demonstrado neste estudo de ecocardiografia Doppler convencional e tecidular&#46; Ocorreu ainda uma redu&#231;&#227;o dos n&#237;veis plasm&#225;ticos de BNP ap&#243;s implanta&#231;&#227;o de VAP&#46;</p></span>"
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age &#40;years&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&#46;9&#177;7&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Gender &#40;male&#47;female&#41;&#44; n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&#47;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BMI &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#46;1&#177;4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">STS score</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;19&#177;3&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Logistic EuroSCORE</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#46;62&#177;6&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">NYHA class IV&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;21&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Diabetes&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;36&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Smoker&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Systemic hypertension&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;61&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">CAD&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;54&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PAD&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;27&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">COPD&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;90&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mild&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Moderate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Severe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Renal failure &#40;CrCl &#60;60 ml&#47;min&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;30&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous CABG&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;12&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous stroke&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Previous PPI&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">AF&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Values are expressed as means &#177; SD or percentages unless otherwise indicated&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">AVA&#58; aortic valve area&#59; AVG&#58; aortic valve gradient&#59; BNP&#58; brain-type natriuretic peptide&#59; DT&#58; deceleration time&#59; IVRT&#58; isovolumetric relaxation time&#59; IVSD&#58; interventricular septal diameter&#59; LA&#58; left atrial&#59; LAd&#58; left atrial anteroposterior diameter&#59; LAVI&#58; left atrial volume index&#59; LV&#58; left ventricular&#59; LVEDD&#58; left ventricular end-diastolic diameter&#59; LVEF&#58; left ventricular ejection fraction&#59; LVESD&#58; left ventricular end-systolic diameter&#59; LVEDV&#58; left ventricular end-diastolic volume&#59; LVESV&#58; left ventricular end-systolic volume&#59; LVSV&#58; left ventricular stroke volume&#59; MPI&#58; myocardial performance index&#59; NS&#58; not significant&#59; NYHA&#58; New York Heart Association&#59; PASP&#58; pulmonary artery systolic pressure&#59; PWD&#58; posterior wall diameter&#59; TAVI&#58; transcatheter aortic valve implantation&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Before TAVI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">After TAVI &#40;1 death&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">NYHA class&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;14&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39 &#40;72&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40 &#40;72&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;9&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;21&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Peak AVG&#44; mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#46;0&#177;18&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#46;2&#177;4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Mean AVG&#44; mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#46;0&#177;15&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;2&#177;2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">AVA&#44; cm</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;6&#177;0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;1&#177;0&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LVEF&#44; &#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51&#46;0&#177;13&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&#46;4&#177;9&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LVEDD&#44; mm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#46;4&#177;7&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#46;2&#177;5&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LVESD&#44; mm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#46;8&#177;9&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31&#46;5&#177;6&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LVEDV&#44; ml</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&#46;6&#177;22&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108&#46;4&#177;22&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LVESV&#44; ml</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#46;6&#177;10&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#46;8&#177;8&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LVSV index&#44; ml&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61&#46;7&#177;16&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#46;0&#177;16&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IVSD&#44; mm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#46;4&#177;1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;1&#177;1&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PWD&#44; mm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;6&#177;1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;7&#177;1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LAd&#44; mm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#46;1&#177;2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#46;0&#177;2&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PASP&#44; mmHg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#46;1&#177;18&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#46;6&#177;11&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">LV MPI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;47&#177;0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;43&#177;0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">E wave&#44; m&#47;s</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;55&#177;0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;75&#177;0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">A wave&#44; m&#47;s</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;75&#177;0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;54&#177;0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">E&#47;A</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;71&#177;0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;36&#177;0&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">DT&#44; ms</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">237&#46;7&#177;20&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">196&#46;9&#177;18&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">IVRT&#44; ms</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">119&#46;5&#177;7&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#46;3&#177;8&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Normal LV diastolic function&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;30&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Grade 1 LV diastolic dysfunction&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;47&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;63&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Grade 2 LV diastolic dysfunction&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;30&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Grade 3 LV diastolic dysfunction&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;21&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Values are expressed as means &#177; standard deviation or means &#40;range&#41;&#46;</p><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Am&#58; late diastolic myocardial velocity&#59; Em&#58; early diastolic myocardial velocity&#59; IVRT&#58; isovolumetric relaxation time&#59; lat&#58; lateral&#59; LV&#58; left ventricular&#59; MPI&#58; myocardial performance index&#59; NS&#58; not significant&#59; sep&#58; septal&#59; Sm&#58; systolic myocardial velocity&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Before TAVI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">After TAVI &#40;3rd month&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat Sm &#40;cm&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;0 &#40;7&#46;0-8&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;0 &#40;8&#46;0-10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat Em &#40;cm&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;0 &#40;7&#46;0-12&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;7 &#40;9&#46;7-15&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat Am &#40;cm&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;8&#177;2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;1&#177;2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat Em&#47;Am&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;83 &#40;0&#46;60-1&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;20 &#40;0&#46;91-1&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat IVRT &#40;ms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99&#46;3&#177;19&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#46;7&#177;13&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV lat MPI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;677&#177;0&#46;025&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;614&#177;0&#46;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep Sm &#40;cm&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;5 &#40;7&#46;0-9&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;0 &#40;8&#46;0-9&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep Em &#40;cm&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;0 &#40;6&#46;0-9&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;0 &#40;7&#46;0-13&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep Am &#40;cm&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;0 &#40;9&#46;0-11&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;0 &#40;8&#46;0-10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep Em&#47;Am&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;80 &#40;0&#46;62-1&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;05 &#40;0&#46;80-1&#46;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep IVRT &#40;ms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">97&#46;0 &#40;80&#46;0-107&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">83&#46;0 &#40;75&#46;5-98&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">LV sep MPI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;696&#177;0&#46;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;604&#177;0&#46;024&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Septal E&#47;e&#8217; ratio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#46;09&#177;1&#46;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;69&#177;1&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lateral E&#47;e&#8217; ratio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#46;67&#177;1&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#46;72&#177;1&#46;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:19 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transcatheter valve implantation for patients with aortic stenosis&#58; a position statement from the European Association of Cardio-Thoracic Surgery &#40;EACTS&#41; and the European Society of Cardiology &#40;ESC&#41;&#44; in collaboration with the European Association of Percutaneous Cardiovascular Interventions &#40;EAPCI&#41;"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Vahanian"
                            1 => "O&#46; Alfieri"
                            2 => "N&#46; Al-Attar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehn183"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2008"
                        "volumen" => "29"
                        "paginaInicial" => "1463"
                        "paginaFinal" => "1470"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18474941"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Heart failure in patients with aortic stenosis&#58; clinical and prognostic significance of carbohydrate antigen 125 and brain natriuretic peptide measurement"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Antonini-Canterin"
                            1 => "B&#46;A&#46; Popescu"
                            2 => "A&#46;C&#46; Popescu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2007.05.039"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2008"
                        "volumen" => "128"
                        "paginaInicial" => "406"
                        "paginaFinal" => "412"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17662495"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Plasma levels of brain and atrial natriuretic peptides elevate in proportion to left ventricular end-systolic wall stress in patients with aortic stenosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Ikeda"
                            1 => "K&#46; Matsuda"
                            2 => "H&#46; Itoh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "1997"
                        "volumen" => "133"
                        "paginaInicial" => "307"
                        "paginaFinal" => "314"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9060799"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
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                0 => array:1 [
                  "referenciaCompleta" => "Ponikowski P&#44; Voors AA&#44; Anker SD&#44; et al&#46; 2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure&#46; Rev Esp Cardiol &#40;Engl Ed&#41;&#46; 2016&#59; 69&#58;1167&#46;"
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relation of N-terminal pro-B-type natriuretic peptide to severity of valvular aortic stenosis"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2004.05.055"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2004"
                        "volumen" => "94"
                        "paginaInicial" => "740"
                        "paginaFinal" => "745"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15374777"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "6"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased plasma natriuretic peptide levels reflect symptoms onset in aortic stenosis"
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                          "etal" => true
                          "autores" => array:3 [
                            0 => "I&#46;L&#46; Gerber"
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                            2 => "M&#46;E&#46; Legget"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.0000060533.79248.0C"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2003"
                        "volumen" => "107"
                        "paginaInicial" => "1884"
                        "paginaFinal" => "1890"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12668523"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0035"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Natriuretic peptides predict symptom-free survival and postoperative outcome in severe aortic stenosis"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Bergler-Klein"
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                    ]
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                      "doi" => "10.1161/01.CIR.0000126825.50903.18"
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                        "paginaFinal" => "2308"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15117847"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Comparison of brain natriuretic peptide plasma levels versus logistic EuroSCORE in predicting in-hospital and late postoperative mortality in patients undergoing aortic valve replacement for symptomatic aortic stenosis"
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                      ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2008.04.055"
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                        "tituloSerie" => "Am J Cardiol"
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                        "link" => array:1 [
                          0 => array:2 [
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                      "titulo" => "Usefulness of B-type natriuretic peptide to predict outcome of patients treated by transcatheter aortic valve implantation"
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                          "autores" => array:3 [
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                        "link" => array:1 [
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                      "titulo" => "Correlation of brain natriuretic peptide levels in patients with severe aortic stenosis undergoing operative valve replacement or percutaneous transcatheter intervention with clinical&#44; echocardiographic&#44; and hemodynamic factors and prognosis"
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                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2013.04.023"
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                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2013"
                        "volumen" => "112"
                        "paginaInicial" => "574"
                        "paginaFinal" => "579"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23683951"
                            "web" => "Medline"
                          ]
                        ]
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                    ]
                  ]
                ]
              ]
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            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
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                0 => array:2 [
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                      "titulo" => "Predictors of outcome in patients with severe aortic stenosis and normal left ventricular function&#58; role of B-type natriuretic peptide"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
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                        ]
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.ehj.2004.09.033"
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                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2004"
                        "volumen" => "25"
                        "paginaInicial" => "2048"
                        "paginaFinal" => "2053"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15541842"
                            "web" => "Medline"
                          ]
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                ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Usefulness of an elevated B-type natriuretic peptide in predicting survival in patients with aortic stenosis treated without surgery"
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                      "titulo" => "Natriuretic peptides and long-term mortality in patients with severe aortic stenosis"
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                          "etal" => true
                          "autores" => array:3 [
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                        "paginaFinal" => "336"
                        "link" => array:1 [
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                ]
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                      "titulo" => "Utility of NT-pro-BNP in patients undergoing transapical aortic valve replacement"
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                            0 => "R&#46; Pfister"
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                        "tituloSerie" => "Clin Res Cardiol"
                        "fecha" => "2010"
                        "volumen" => "99"
                        "paginaInicial" => "301"
                        "paginaFinal" => "307"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20140438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Relation of N-terminal pro-B-type natriuretic peptide to progression of aortic valve disease"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
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                            2 => "M&#46; Rau"
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                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehi236"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2005"
                        "volumen" => "26"
                        "paginaInicial" => "1023"
                        "paginaFinal" => "1030"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15781428"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The predictive value and evolution of N-terminal pro-B-type natriuretic peptide levels following transcutaneous aortic valve implantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "K&#46; Spargias"
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                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1111/j.1540-8183.2011.00654.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Intervent Cardiol"
                        "fecha" => "2011"
                        "volumen" => "24"
                        "paginaInicial" => "462"
                        "paginaFinal" => "469"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21883470"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Impact of serial B-type natriuretic peptide changes for predicting outcome in asymptomatic patients with aortic stenosis"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Henri"
                            1 => "R&#46; Dulgheru"
                            2 => "J&#46; Magne"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cjca.2015.06.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Cardiol"
                        "fecha" => "2016"
                        "volumen" => "32"
                        "paginaInicial" => "183"
                        "paginaFinal" => "189"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26371385"
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                ]
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                      "titulo" => "Myokard Performans &#304;ndeksi-Derleme"
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                            0 => "A&#46; Ulucay"
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                      "Revista" => array:6 [
                        "tituloSerie" => "Anadolu Kardiyol Derg"
                        "fecha" => "2008"
                        "volumen" => "8"
                        "paginaInicial" => "143"
                        "paginaFinal" => "148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18400636"
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                    ]
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                ]
              ]
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              "etiqueta" => "19"
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                      "titulo" => "Validation of myocardial acceleration during isovolumic contraction as a novel noninvasive index of right ventricular contractility&#59; comparison with ventricular pressure-volume relations in an animal model"
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                        0 => array:2 [
                          "etal" => true
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                    ]
                  ]
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                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2002"
                        "volumen" => "105"
                        "paginaInicial" => "1693"
                        "paginaFinal" => "1699"
                        "link" => array:1 [
                          0 => array:2 [
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Article information

ISSN: 21742049
Original language: English

DOI:10.1016/j.repce.2016.10.018

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	5	3	8
2024 October	29	28	57
2024 September	31	24	55
2024 August	44	25	69
2024 July	35	27	62
2024 June	28	12	40
2024 May	26	21	47
2024 April	20	22	42
2024 March	26	18	44
2024 February	24	24	48
2024 January	17	22	39
2023 December	26	24	50
2023 November	22	25	47
2023 October	18	12	30
2023 September	23	19	42
2023 August	19	18	37
2023 July	27	10	37
2023 June	21	10	31
2023 May	35	18	53
2023 April	16	4	20
2023 March	19	18	37
2023 February	27	17	44
2023 January	18	14	32
2022 December	27	22	49
2022 November	31	20	51
2022 October	22	17	39
2022 September	37	29	66
2022 August	31	21	52
2022 July	24	27	51
2022 June	27	19	46
2022 May	14	24	38
2022 April	26	33	59
2022 March	29	45	74
2022 February	25	34	59
2022 January	23	25	48
2021 December	23	28	51
2021 November	31	34	65
2021 October	39	42	81
2021 September	21	32	53
2021 August	30	27	57
2021 July	22	26	48
2021 June	26	20	46
2021 May	36	36	72
2021 April	40	48	88
2021 March	40	20	60
2021 February	92	21	113
2021 January	34	14	48
2020 December	28	10	38
2020 November	34	10	44
2020 October	10	9	19
2020 September	53	5	58
2020 August	22	4	26
2020 July	49	9	58
2020 June	39	10	49
2020 May	50	4	54
2020 April	41	11	52
2020 March	50	8	58
2020 February	50	18	68
2020 January	34	6	40
2019 December	33	6	39
2019 November	42	10	52
2019 October	34	5	39
2019 September	29	9	38
2019 August	20	9	29
2019 July	46	13	59
2019 June	34	10	44
2019 May	52	10	62
2019 April	20	19	39
2019 March	71	7	78
2019 February	89	7	96
2019 January	24	6	30
2018 December	31	9	40
2018 November	74	10	84
2018 October	128	13	141
2018 September	24	12	36
2018 August	29	19	48
2018 July	15	5	20
2018 June	20	8	28
2018 May	28	7	35
2018 April	28	2	30
2018 March	39	5	44
2018 February	18	3	21
2018 January	25	9	34
2017 December	38	10	48
2017 November	26	16	42
2017 October	35	11	46
2017 September	39	20	59
2017 August	48	17	65
2017 July	30	16	46
2017 June	40	21	61

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