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Left ventricular dysfunction and TAVI – predictors of recovery and outcomes
Session:
SESSÃO DE POSTERS 20 - IC E INTERVENÇÃO VALVULAR
Speaker:
Miguel Azaredo Raposo
Congress:
CPC 2025
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.4 Chronic Heart Failure – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Miguel Azaredo Raposo; Catarina Gregório; Ana Abrantes; João Cravo; Marta Vilela; Diogo Ferreira; Daniel Cazeiro; Pedro Carrilho Ferreira; João Silva Marques; Miguel Nobre Menezes; Cláudia Jorge; Fausto J. Pinto
Abstract
<p><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="font-family:Aptos,sans-serif">Introduction: </span></strong><span style="font-family:Aptos,sans-serif">Left ventricular ejection fraction (LVEF) recovery after TAVI influences long-term outcomes, being linked to better functional capacity and reduced mortality. However, not all patients experience significant recovery, highlighting the need to identify predictors to optimize patient selection and post-procedural care.</span></span></span></span></p> <div> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="font-family:Aptos,sans-serif">Purpose: </span></strong><span style="font-family:Aptos,sans-serif">We aimed to identify predictors of post-TAVI LVEF normalization at 1-year follow-up (FUP)and compare outcomes of these patients (pts) with those who had persistent LV dysfunction.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="font-family:Aptos,sans-serif">Methods: </span></strong><span style="font-family:Aptos,sans-serif">We selected pts from a single center TAVI registry – pts submitted to the procedure from 2012 to 2023 – who had baseline LVEF <50%. Clinical and echocardiographic data were analyzed. For statistical analysis, Independent t-test and Chi-square were applied. Kaplan-Meier curves were drawn and cox regressions performed to analyze mortality. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="font-family:Aptos,sans-serif">Results: </span></strong><span style="font-family:Aptos,sans-serif">We included 158 pts, 52,5% were male, with mean age of 80.8±6,7 years. Mean time of FUP was 38,9±26 months. Mean EF prior to TAVI was 37,7±8%, with 20% of pts with LVEF<30%. Regarding cardiovascular risk factors, 90% had hypertension, 74% dyslipidemia, 40% diabetes mellitus, and 38% CKD. 33% of pts had coronary heart disease, with 22% having underwent percutaneous angioplasty and 11,5% CABG. Median NTproBNP at baseline was 4755 (IQR 7747) ng/L. 54.4% of pts had a balloon-expandable valve implanted and 45.6% a self-expandable. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="font-family:Aptos,sans-serif">Regarding predictors of LVEF at FUP, we found female sex to be a protective factor (p=0.03 OR 4.2). Coronary artery disease (p=0.05 OR 0.49) and baseline LVEF <30% were found to be associated with smaller odd of normalization.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="font-family:Aptos,sans-serif">Patients who recovered LVEF by at least 10% had a 56.2% lower hazard of death at FUP comparing to the remaining population (p=0.023; HR 0.438). LVEF recuperation to >50% was also associated with a lower hazard of death at FUP (p=0.05; HR 0.569).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="font-family:Aptos,sans-serif">Conclusion: </span></strong><span style="font-family:Aptos,sans-serif">LVEF recovery post TAVI significatively impacts survival. An increase of 10% or higher by 1-year post-procedure reduced hazard of death at a mean FUP of 39 months by 56%. Women have an increased odd of recovering LVEF and pts with a baseline EF<30% and those with coronary disease have a decreased odd of normalizing LV function. </span></span></span></span></p> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div> </div> <div id="accel-snackbar" style="left:50%; top:50px; transform:translate(-50%, 0px)"> </div>
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