Left Ventricular Diastolic Dysfunction After Transcatheter Aortic Valve Replacement: 1-Year Efficacy and Mortality Outcomes
Journal of the American College of Cardiology
Background: Long term outcomes in left ventricular diastolic dysfunction (LVDD) after transcatheter aortic valve replacement (TAVR) remain controversial. The aim of this study is to evaluate the efficacy and mortality in LVDD in severe aortic stenosis patients before and 1-year after TAVR. Methods: A retrospective study was conducted for TAVR patients at Beaumont Hospital from 2015-2019. Patient demographics, LVDD grades with the latest echocardiography guidelines, New York Heart Association (NYHA) Classification, and mortality were collected. Baseline data were compared to 1-year follow up. Descriptive statistics, chi-square, and log-rank were used. Results: 221 patients were in the final analysis. Advanced stages of baseline pre-TAVR LVDD grades correlated with low EF < 50% (p = 0.014) and increased NYHA III-IV (p = 0.031). LVDD grades post-TAVR illustrated most improvements in advanced grades (p = 0.041) with notable decrease in LVDD ≥ Grade 2 from 80% (n = 96 of 119) to 64% (n = 76 of 119). Furthermore, significant improvements in NYHA III-IV were observed across all grades (p = 0.016). Mean survival time decreased with advanced LVDD grades (Grade 1, 5.50 ± 0.33 years; Grade 2, 5.02 ± 0.20 years; Grade 3, 4.18 ± 0.36 years), though probability of death did not reach statistical significance (p = 0.315).Conclusion: Post-TAVR improvements were observed in LVDD grades and NYHA classifications, most notably in advanced grades. Probability of death was not significant across baseline LVDD grades.
Pathangey G, Hanzel GS, Shannon FL, Hanson I, Lau W, Vivacqua A, et al. [Abbas AE]. Left ventricular diastolic dysfunction after transcatheter aortic valve replacement: 1-year efficacy and mortality outcomes. J Am Coll Cardiol. 2023 Mar;81(8 Suppl.A):1022. doi:10.1016/S0735-1097(23)01466-3