Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement
Background: A staging system based on cardiac damage for severe aortic stenosis (AS) has been validated for prognosis prediction following transcatheter aortic valve replacement (TAVR). Our study aims to investigate whether TAVR can lead to changes in cardiac damage shortly after the procedure and h...
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2025-01-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| author | Hao-Wei Lee Chih-Hui Chin Po-chin Chou Chia-Hsiu Chang Chiu-Ling Tsai Chi-Hung Huang |
| author_facet | Hao-Wei Lee Chih-Hui Chin Po-chin Chou Chia-Hsiu Chang Chiu-Ling Tsai Chi-Hung Huang |
| author_sort | Hao-Wei Lee |
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| description | Background: A staging system based on cardiac damage for severe aortic stenosis (AS) has been validated for prognosis prediction following transcatheter aortic valve replacement (TAVR). Our study aims to investigate whether TAVR can lead to changes in cardiac damage shortly after the procedure and how these changes impact prognosis. Method: Patients in this retrospective cohort study were classified into five stages (0–4) before TAVR based on the echocardiographic findings of cardiac damage. The closest echocardiogram after TAVR was used for restaging cardiac damage. The primary composite outcome was all-cause mortality or hospitalization due to heart failure (HF). Results: A total of 64 patients were enrolled (53.1% male, mean age 81.7 ± 7.7 years). Within a mean interval of 4 days (interquartile range = 3 to 7 days) after TAVR, cardiac damage improved in 25.0% of patients, while it worsened in 20.3%. During a median follow-up of 2.5 ± 1.9 years, 34.4% of patients met the primary endpoint, which included 16 deaths and 6 HF hospitalizations. Cox regression analysis revealed that improvement in cardiac damage correlated with a lower risk of composite death or HF hospitalization (HR: 0.095; 95% CI: 0.014–0.627; <i>p</i> = 0.015). Conclusions: TAVR can lead to changes in cardiac damage over a short period in patients with severe AS, and rapid improvement in cardiac damage after TAVR is associated with a better prognosis. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-1ca591e5070d4a87a776f534b1e84b8d2025-01-24T13:36:03ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-01-011212910.3390/jcdd12010029Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve ReplacementHao-Wei Lee0Chih-Hui Chin1Po-chin Chou2Chia-Hsiu Chang3Chiu-Ling Tsai4Chi-Hung Huang5General Cardiology, Cardiovascular Center, Cathay General Hospital, Taipei 106, TaiwanGeneral Cardiology, Cardiovascular Center, Cathay General Hospital, Taipei 106, TaiwanInterventional Cardiology, Cardiovascular Center, Cathay General Hospital, Taipei 106, TaiwanInterventional Cardiology, Cardiovascular Center, Cathay General Hospital, Taipei 106, TaiwanDivision of Cardiovascular Surgery, Cardiovascular Center, Cathay General Hospital, Taipei 106, TaiwanCardiovascular Center, Cathay General Hospital, Taipei 106, TaiwanBackground: A staging system based on cardiac damage for severe aortic stenosis (AS) has been validated for prognosis prediction following transcatheter aortic valve replacement (TAVR). Our study aims to investigate whether TAVR can lead to changes in cardiac damage shortly after the procedure and how these changes impact prognosis. Method: Patients in this retrospective cohort study were classified into five stages (0–4) before TAVR based on the echocardiographic findings of cardiac damage. The closest echocardiogram after TAVR was used for restaging cardiac damage. The primary composite outcome was all-cause mortality or hospitalization due to heart failure (HF). Results: A total of 64 patients were enrolled (53.1% male, mean age 81.7 ± 7.7 years). Within a mean interval of 4 days (interquartile range = 3 to 7 days) after TAVR, cardiac damage improved in 25.0% of patients, while it worsened in 20.3%. During a median follow-up of 2.5 ± 1.9 years, 34.4% of patients met the primary endpoint, which included 16 deaths and 6 HF hospitalizations. Cox regression analysis revealed that improvement in cardiac damage correlated with a lower risk of composite death or HF hospitalization (HR: 0.095; 95% CI: 0.014–0.627; <i>p</i> = 0.015). Conclusions: TAVR can lead to changes in cardiac damage over a short period in patients with severe AS, and rapid improvement in cardiac damage after TAVR is associated with a better prognosis.https://www.mdpi.com/2308-3425/12/1/29severe aortic stenosiscardiac damagetranscatheter aortic valve replacement |
| spellingShingle | Hao-Wei Lee Chih-Hui Chin Po-chin Chou Chia-Hsiu Chang Chiu-Ling Tsai Chi-Hung Huang Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement Journal of Cardiovascular Development and Disease severe aortic stenosis cardiac damage transcatheter aortic valve replacement |
| title | Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement |
| title_full | Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement |
| title_fullStr | Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement |
| title_full_unstemmed | Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement |
| title_short | Rapid Improvement in Cardiac Damage Predicts Better Prognosis After Transcatheter Aortic Valve Replacement |
| title_sort | rapid improvement in cardiac damage predicts better prognosis after transcatheter aortic valve replacement |
| topic | severe aortic stenosis cardiac damage transcatheter aortic valve replacement |
| url | https://www.mdpi.com/2308-3425/12/1/29 |
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