Journal of echocardiography · 2026
Echocardiographic predictors of left ventricular ejection fraction improvement after transcatheter aortic valve replacement.
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Sato Shin, Kumagai Akiko, Ninomiya Kai, Murofushi Akiko, Shimada Kaho, Yoshizawa Michiko, Ninomiya Ryo, Fusazaki Tetsuya, Morino Yoshihiro
Аннотация
BACKGROUND: Improvement in left ventricular ejection fraction (LVEF) after transcatheter aortic valve replacement (TAVR) has been associated with better clinical outcomes, but predictors of recovery remain poorly defined. This study aimed to identify echocardiographic parameters associated with post-TAVR LVEF improvement in patients with severe aortic stenosis (AS) and reduced LVEF.
METHODS: Among 1,133 consecutive patients who underwent TAVR between December 2013 and June 2024, 128 with baseline LVEF < 50% and follow-up echocardiography within 3 months were analyzed. LVEF improvement was defined as an absolute increase ≥ 10%. Independent predictors were identified using multivariable logistic regression. Post-procedural outcomes were assessed using Kaplan-Meier analysis.
RESULTS: LVEF improvement occurred in 64 patients (50%). Multivariable analysis identified higher left ventricular mass index (LVMI) (OR 1.02, 95% CI 1.00-1.03, P = 0.01) and higher E/e' (OR 1.10, 95% CI 1.03-1.18, P < 0.01) as independent predictors of improvement, whereas larger left ventricular end-diastolic volume (LVEDV) (OR 0.98, P = 0.01) and larger AVA (OR 0.67 per 0.1 cm², P < 0.01) were inversely associated. Patients with LVEF improvement had significantly lower 1-year all-cause mortality (98.2% vs. 87.0%, P = 0.01).
CONCLUSIONS: Echocardiographic parameters reflecting pressure overload and diastolic dysfunction predict LVEF recovery after TAVR. Postoperative LVEF improvement was associated with better 1-year survival, underscoring its prognostic value.
METHODS: Among 1,133 consecutive patients who underwent TAVR between December 2013 and June 2024, 128 with baseline LVEF < 50% and follow-up echocardiography within 3 months were analyzed. LVEF improvement was defined as an absolute increase ≥ 10%. Independent predictors were identified using multivariable logistic regression. Post-procedural outcomes were assessed using Kaplan-Meier analysis.
RESULTS: LVEF improvement occurred in 64 patients (50%). Multivariable analysis identified higher left ventricular mass index (LVMI) (OR 1.02, 95% CI 1.00-1.03, P = 0.01) and higher E/e' (OR 1.10, 95% CI 1.03-1.18, P < 0.01) as independent predictors of improvement, whereas larger left ventricular end-diastolic volume (LVEDV) (OR 0.98, P = 0.01) and larger AVA (OR 0.67 per 0.1 cm², P < 0.01) were inversely associated. Patients with LVEF improvement had significantly lower 1-year all-cause mortality (98.2% vs. 87.0%, P = 0.01).
CONCLUSIONS: Echocardiographic parameters reflecting pressure overload and diastolic dysfunction predict LVEF recovery after TAVR. Postoperative LVEF improvement was associated with better 1-year survival, underscoring its prognostic value.