Aortic stenosis and the evolution of cardiac damage after transcatheter aortic valve replacement

Abstract Aims Cardiac damage staging has been postulated as a prognostic tool in patients undergoing transcatheter aortic valve replacement (TAVR). The aim of our study is to show the echocardiographic and clinical outcome of patients one-year after TAVR. Methods and results Patients undergoing TAVR from 2017 to 2021 were included in a single-centre prospective registry. Transthoracic echocardiography was performed in all patients before TAVR and at one-year. Patients were classified according to a previously published staging model.1 496 patients (mean age 82.1±5.9 years, 53% female) were included. At baseline, Stage 0 included 24.5% of patients, Stage 1 included 42.8%, Stage 2 included 16.5%, and Stage 3 included 16.2% of patients. One-year overall mortality was 17.7% (n=88). Among patients who survived, after one-year of follow-up, the higher the baseline stage of cardiac damage, patients showed larger LVEDV (p= 0.223), LV mass (p= 0.207) and LAVI (p= <0.001); higher E/e’ ratio (p= 0.284) and PASP (p= <0.001). As for LVEF, at one-year; it was significantly lower the higher the baseline stage of cardiac damage (p= 0.005); the same was observed with GLS (p= <0.001) and right ventricle-arterial coupling (p= <0.001), Table 1. Conclusions The higher the stage of initial cardiac damage, the lower the possibility of morphological and functional improvement, despite undergoing TAVR. The use of staging systems and earlier intervention could help improve the prognosis of these patients.