Five-meter walk test before transcatheter aortic valve replacement and 1-year noncardiac mortalityCentral MessagePerspective
Toshinobu Kazui, MD, PhD,
Chiu-Hsieh Hsu, PhD,
Mohammad Hamidi, MD,
Deepak Acharya, MD, MPH,
Madhan Shanmugasundaram, MD,
Kwan Lee, MD,
Arka Chatterjee, MD,
David Bull, MD
Affiliations
Toshinobu Kazui, MD, PhD
Division of Cardiothoracic Surgery, Department of Surgery, Banner University Medical Center-Tucson/University of Arizona, Tucson, Ariz; Department of Surgery, Banner University Medical Center-Tucson/University of Arizona, Tucson, Ariz; Address for reprints: Toshinobu Kazui, MD, PhD, Division of Cardiothoracic Surgery, The University of Arizona/Banner University Medical Center-Tucson, 1501 N Campbell Ave, Rm 4302, PO Box 245071, Tucson, AZ 85724-5071.
Chiu-Hsieh Hsu, PhD
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Ariz
Mohammad Hamidi, MD
Department of Surgery, Banner University Medical Center-Tucson/University of Arizona, Tucson, Ariz
Deepak Acharya, MD, MPH
Division of Cardiology, Department of Medicine, Sarver Heart Center, Banner University Medical Center-Tucson/University of Arizona, Tucson, Ariz
Madhan Shanmugasundaram, MD
Division of Cardiology, Department of Medicine, Sarver Heart Center, Banner University Medical Center-Tucson/University of Arizona, Tucson, Ariz
Kwan Lee, MD
Division of Cardiology, Department of Medicine, Sarver Heart Center, Banner University Medical Center-Tucson/University of Arizona, Tucson, Ariz
Arka Chatterjee, MD
Division of Cardiology, Department of Medicine, Sarver Heart Center, Banner University Medical Center-Tucson/University of Arizona, Tucson, Ariz
David Bull, MD
Division of Cardiothoracic Surgery, Department of Surgery, Banner University Medical Center-Tucson/University of Arizona, Tucson, Ariz; Department of Surgery, Banner University Medical Center-Tucson/University of Arizona, Tucson, Ariz
Objective: The purpose of this study is to assess whether the 5-m walk test is associated with 1-year mortality after transcatheter aortic valve replacement. Methods: Included in the analysis were 304 patients who received the 5-m walk test and underwent transcatheter aortic valve replacement from September 2012 to March 2019. They were classified into 3 groups based on their test score: ≤7, >7, and unable to walk. Preprocedure characteristics, postprocedure outcomes, and follow-up outcomes were compared between the groups. Results: For the 5-m walk test, 145 had a score ≤7 (Group N), 111 had a score >7 (Group S), and 48 were unable to walk (Group I). Average age in years was 80.2 ± 8.7 years in Group N, 81.2 ± 9.4 years in Group S, and 79.4 ± 9.2 in Group I (P = .23). The aortic valve mean gradient at discharge was 9.5 ± 4.1 mm Hg in Group N, 10.4 ± 5.5 mm Hg in Group S, and 8.2 ± 4.2 mm Hg in Group I (P = .05). The discharge survival was 97.2% in Group N, 96.4% in Group S, and 95.8% in Group I (P = .76). One-year survival was 92.8% in Group N, 84.1% in Group S, and 75% in Group I (P < .01) after adjusting for preprocedure characteristics. Noncardiac death was 5.1% in Group N, 13.1% in Group S, and 22.7% in Group I (P = .03). This indicates that the 5-m walk test was a risk factor for 1-year mortality. More specifically, a poor 5-m walk test score was associated with 1-year noncardiac mortality. Conclusions: The 5-m walk test score before transcatheter aortic valve replacement was associated with 1-year mortality, especially noncardiac mortality. It may help identify patients at high risk for 1-year mortality.
