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Left ventricular ejection fraction Improvement after Transcatheter Aortic Valve Replacement – predictors and prognosis
Session:
SESSÃO DE POSTERS 34 - TAVI 2
Speaker:
Marta Paralta De Figueiredo
Congress:
CPC 2025
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
Marta Paralta De Figueiredo; Antonio Almeida; Rafael Viana; Rita Louro; Miguel Carias; Orlado Luquengo; Filipe Alpalhao; Bruno Piçarra; David Neves; Angela Bento; Renato Fernandes; Lino Patricio
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Introduction: Transcatheter aortic valve replacement (TAVI) has become an effective and safe approach towards patients with severe aortic stenosis (AS). While severe AS is known to negatively impact left ventricular ejection fraction (LVEF), previous studies have suggested that TAVI can lead to an improvement in LVEF and outcomes. However, predictors of improvement are not clearly identified. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Purpose: Our aim is to characterize a population of patients submitted to TAVI with LVEF<40%, verify if there is an improvement in LVEF after TAVI and determine possible predictors.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods: We retrospectively analyzed patients submitted to TAVI in our institution between 2021 and 2024 and selected those with LVEF<40%. We documented demographic characteristics, clinical presentation, risk scores, echocardiographic data pre-TAVI and 3 months after, CT-scan data, TAVI-procedure details, complications and follow-up. We then performed univariate analysis to establish the relationship between variables and multivariate analysis to identify independent predictors.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results: Out of 300 patients, we selected 12,3% (n=37) that had LVEF<40%, with a mean LVEF of 32±5,7%. In terms of demographic factors - 62% were male (n=23) with a mean age of 82±4,6years, 81% were hypertense and has dyslipidemia, 49% were diabetic, 19% were smokers and 32% had established coronary artery disease (CAD). At a 3-month reassessment post-TAVI, 67,6% had a statistically significant increase in LVEF of 17,3±10,8% (p<0,001). History of CAD was associated with lack of improvement (62,5% vs 24%, p=0,044), as was pacemaker implantation after TAVI (PM) (43%vs 4%, p= 0,006), with only the latter remaining an independent predictor in multivariate analysis (p=0,033). There were no differences regarding rehospitalization and no deaths were observed during the follow up period (317±75 days) .</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion: In patients with AS and reduced LVEF submitted to TAVI there was a significant early improvement in LVEF after the procedure. Those with CAD or definitive PM were less likely to experience LVEF recovery. Although no differences regarding rehospitalization and no deaths were observed during the follow up period, further studies with a larger population are required.</span></span></p>
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