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Purpose <p>We evaluated the 1-year clinical outcomes (all-cause mortality, heart failure rehospitalization, and their composite) in patients with severe aortic stenosis (AS) and a preoperative left ventricular ejection fraction (LVEF) &lt; 50% who underwent transcatheter aortic valve replacement (TAVR), and examined the baseline factors predicting ≥ 10% early LVEF improvement.</p> Methods <p>We retrospectively analyzed 44 patients who underwent TAVR and divided them into Group R (≥ 10% LVEF improvement, n = 25) or Group N (&lt; 10% improvement, n = 19). A Kaplan–Meier analysis was used to assess the survival rates, and multivariable logistic regression was applied to identify the predictors of LVEF improvement.</p> Results <p>The mean patient age was 84.8 ± 4.8 years, and 40.9% were male. Post-TAVR, 56.8% of patients showed ≥ 10% LVEF improvement (mean increase: 16.7 ± 6.1%). The one-year mortality was similar between the groups (<i>p</i> = 0.383), whereas the composite endpoint tended to be higher in Group N (0.4% vs. 21.1%, <i>p</i> = 0.072). The peak aortic valve velocity was the only significant predictor (OR = 0.255, <i>p</i> = 0.048; cutoff: 4.45 m/s, sensitivity, 0.840; specificity, 0.684).</p> Conclusion <p>In patients with severe AS and a preoperative LVEF of &lt; 50%, 56.8% demonstrated a significant early LVEF improvement post-TAVR. Patients with a ≥ 10% improvement had a significantly lower 1-year mortality rate.</p>

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Impact of an improvement in the early left ventricular ejection fraction on the 1-year clinical outcomes and its predictors after transcatheter aortic valve replacement

  • 期刊论文

  • 发表日期：

    2025年5月3日

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  • Ikuko Shibasaki,
  • Yusuke Takei,
  • Suguru Hirose,
  • Michiaki Tokura,
  • Masahiro Tezuka,
  • Shohei Yokoyama,
  • Ryujiro Suzuki,
  • Riichi Nishikawa,
  • Shu Inami,
  • Yasuo Haruyama,
  • Shigeru Toyoda,
  • Hirotsugu Fukuda

摘要

Purpose

We evaluated the 1-year clinical outcomes (all-cause mortality, heart failure rehospitalization, and their composite) in patients with severe aortic stenosis (AS) and a preoperative left ventricular ejection fraction (LVEF) < 50% who underwent transcatheter aortic valve replacement (TAVR), and examined the baseline factors predicting ≥ 10% early LVEF improvement.

Methods

We retrospectively analyzed 44 patients who underwent TAVR and divided them into Group R (≥ 10% LVEF improvement, n = 25) or Group N (< 10% improvement, n = 19). A Kaplan–Meier analysis was used to assess the survival rates, and multivariable logistic regression was applied to identify the predictors of LVEF improvement.

Results

The mean patient age was 84.8 ± 4.8 years, and 40.9% were male. Post-TAVR, 56.8% of patients showed ≥ 10% LVEF improvement (mean increase: 16.7 ± 6.1%). The one-year mortality was similar between the groups (p = 0.383), whereas the composite endpoint tended to be higher in Group N (0.4% vs. 21.1%, p = 0.072). The peak aortic valve velocity was the only significant predictor (OR = 0.255, p = 0.048; cutoff: 4.45 m/s, sensitivity, 0.840; specificity, 0.684).

Conclusion

In patients with severe AS and a preoperative LVEF of < 50%, 56.8% demonstrated a significant early LVEF improvement post-TAVR. Patients with a ≥ 10% improvement had a significantly lower 1-year mortality rate.