Does heart pumping function improve after catheter-based valve replacement for severe aortic stenosis?

Details

Long-standing aortic stenosis (AS) raises pressure in the left ventricle (LV), leading to LV hypertrophy and increased fibrosis in the heart muscle. Left ventricular ejection fraction (LVEF), a measure of pumping function, often remains preserved until late in the disease, although subtle LV dysfunction can be present in severe AS.

Transcatheter aortic valve replacement (TAVR) has become the primary method of aortic valve replacement for patients with AS who have intermediate or high surgical risk. This study asked whether TAVR in patients with severe AS could improve systolic function—the heart's ability to pump during contraction.

The researchers retrospectively studied data from 52 consecutive symptomatic patients with severe AS who underwent TAVR at their center. Echocardiography was performed at baseline and 6 months after the procedure to evaluate changes in LVEF.

All 52 patients were retrospectively evaluated. Mean LVEF was 49.52 ± 13.44 before TAVR and 52.02 ± 10.95 after TAVR. The increase after TAVR compared with before TAVR was statistically significant (P = 0.008, Wilcoxon signed-rank test).

The authors concluded that removing afterload—the load against which the heart pumps—through TAVR significantly improves cardiac function in AS patients, as assessed by LVEF.