Preoperative Instrumental Activities of Daily Living Predicts Survival After Transcatheter Aortic Valve Implantation

To the Editor:

I have read with great interest the article entitled “Preoperative Instrumental Activities of Daily Living Predicts Survival after Transcatheter Aortic Valve Implantation” by Fukui et al.¹ The article pointed out that preoperative walking speed and instrumental activities of daily living are important factors associated with mid- and long-term mortality after transcatheter aortic valve implantation (TAVI).

However, the authors did not collect left ventricular diameter or pulmonary artery systolic pressure (PASP) data. Ujihira et al² reported the left ventricular end-diastolic diameter >50 mm was a predictor of PASP deterioration, regardless of baseline PASP, and that patients with increased PASP at 1 month after successful TAVI were at higher risk of mortality and rehospitalization within 1 year. Increased PASP can also affect a patient’s walking speed, so I believe it is better to add these 2 parameters in order to come a more accurate conclusion. Furthermore, left ventricular diameter and PASP constitute confounding bias, so subgroup analysis and further discussion could enable more rigorous conclusions to be drawn.

Disclosures

The author has no conflicts of interest to disclose.

• Zeyi Cheng, MD
• Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China

References

• 1.   Fukui S, Kawakami M, Otaka Y, Ishikawa A, Yashima F, Hayashida K, et al. Preoperative instrumental activities of daily living predicts survival after transcatheter aortic valve implantation. Circ Rep 2020; 2: 83–88.
• 2.   Ujihira K, Kohmoto T, Gimelli G, Raval A, Jacobson K, Wolff M, et al. The impact of increased pulmonary arterial pressure on outcomes after transcatheter aortic valve replacement. Catheter Cardiovasc Interv, doi:10.1002/ccd.28862.