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, Le mismatch patient-prothèse (MPP) est défini par une surface valvulaire effective indexée (SVEi) ? 0,85cm²/m² et est associé à un impact pronostic péjoratif. Les patients avec un indice de masse corporelle (IMC) ? 30kg/m² semblent protégés de ses conséquences

, Ils résident dans la confirmation du paradoxe du l'obésité au sein de notre population de patients implantés d'endoprothèse valvulaire TAVI pour une sténose aortique serrée et dans la détermination d'un seuil pronostique de SVEi permettant de redéfinir le MPP au sein de cette population

;. Ils-s'agit-d'une-Étude-monocentrique-menée-entre-février and . Mai, Les patients ayant bénéficié de l'implantation d'une endoprothèse valvulaire aortique ballon-expansible ou auto-expansible pour une sténose aortique serrée symptomatique ont été consécutivement inclus. Le critère de jugement principal était un critère composite associant la mortalité toutes causes et/ou la survenue d'une hospitalisation pour de l'insuffisance cardiaque à 1an. Les critères de jugement secondaire était la mortalité toutes causes et la survenue d, 2015.

, Le seuil de 0,85 cm²/m² n'était pas discriminant pour les patients avec un IMC ? 25kg/m² alors que le seuil de SVEi ? 0,65cm²/m² permettait de distinguer les patients à risque de présenter le critère composite. Avec ce nouveau seuil, Quatre-cent soixante-dix-sept patients consécutifs étaient inclus. L'âge moyen était de 82,12±5,96 ans avec une majorité d'hommes (50,52%). L'IMC moyen était de 26,19 ± 4,48 kg/m2, p.43

, Les patients avec un IMC ? 25kg/m² présentent un avantage pronostique qui illustre le paradoxe du « surpoids/obésité » et rend obsolète la définition actuelle du MPP dans cette population

, Mots-clefs : Mismatch patient-prothèse, TAVI, obésité, mortalité