Extent of Cardiac Damage and Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation (original) (raw)

2021, Research Square (Research Square)

We sought to assess the prognostic role of the extent of cardiac damage among real-world patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). Methods A staging classi cation was applied to 262 patients from the EffecTAVI Registry at baseline and reassessed within 30-day after TAVI. All-cause mortality at 1-year was the primary endpoint of the study. Cerebrovascular accident, myocardial infarction, permanent pacemaker implantation, endocarditis and rehospitalization for all caused were included as secondary endpoints. Results At baseline, 23 (8.7%) patients were in Stage 0/1 (no cardiac damage/left ventricular damage), 106 (40.4%) in Stage 2 (left atrial or mitral valve damage), 59 (22.5%) in Stage 3 (pulmonary vasculature or tricuspid valve damage) and 74 (28.3%) in Stage 4 (right ventricular damage). At 30-day after TAVI, a lower prevalence of advanced stages of cardiac damage than baseline, mainly driven by a signi cant improvement in left ventricular diastolic parameters and right ventricular function, was reported. At 1-year, a stepwise increase in mortality rates was observed according to staging at baseline: 4.3% in Stage 0/1, 6.6% in Stage 2, 18.6% in Stage 3 and 21.6% in Stage 4 (p= 0.08). No differences were found in secondary endpoints. Conclusions Although TAVI might be associated with an amelioration of the left ventricular diastolic and right ventricular function, patients with a greater extent of cardiac damage at baseline are at higher risk of mortality at 1-year after the procedure.