Journal Wrap | According to results from a systematic review published in Annals of Internal Medicine, patients undergoing transcatheter aortic valve replacement (TAVR) experience clinically important benefits in functional status and quality of life. Kim et al. analyzed data from 60 observational studies and two randomized controlled trials (encompassing 11,205 patients) that reported NYHA class, Short Form-12/36 Health Survey physical and mental component summary, and other measures of functional status. Notably, most of the included studies were not direct comparisons, but evaluated data before and after the intervention.

Across the studies' populations, 54–100% of patients had NYHA class III or IV symptoms at baseline. Most studies showed a clinically important decrease in NYHA class at 6 to 11 months (range = -0.8 to -2.1 classes) and 12 to 23 months (range = -0.8 to -2.1 classes). Over 12 months, improvement in the physical component score was clinically important (range = 4.9 to 26.9 points); change in mental component score was smaller (range = 1.0 to 8.9 points).

Clinically important improvements were seen in other disease-specific measures but were less consistently seen in general health measures. Given the lack of head-to-head comparisons, the authors concluded, further research into functional outcomes with TAVR is needed.

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Kim CA, Rasania SP, Afilalo J, et al. Ann Intern Med. 2014;160:243-54.

Keywords: Quality of Life, Health Surveys, CardioSource WorldNews, ACC Publications

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