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February 8, 2026European Heart Journal0 citations

Clinical Outcomes and Predictors of Mortality in TAVI Patients with Varying Baseline Gradients

Clinical outcomes and predictors of mortality in TAVI patients with high, low and very low baseline gradient. Analysis of the Spanish TAVI registry

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Why the study?

Does baseline mean gradient (high, low, very low) affect 2-year survival and the predictive value of risk scores in patients undergoing TAVI?

Population

17,421 patients undergoing TAVI between 2010 and 2024 from the Spanish TAVI registry, divided into high…

Comparison

Transcatheter Aortic Valve Implantation in… vs TAVI in patients with high baseline mean gradient

Design

Cohort

Follow-up

2 years

Key result

TAVI patients with very low gradient (≤20 mmHg) had higher 2-year mortality (74%) vs high gradient (83%), with HR 1.6; STS score and LVEF predicted mortality best in VLG.

Authors

JHJ M De La Torre HernandezRHRafael Hernández HernándezGVGabriela Xavier Veiga

Discussion

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Overview

VLG TAVI patients show higher mortality; supports low-gradient risk observations but leaves management implications open.

Key Points

  • The research aims to analyze patient profiles with varying baseline gradients and evaluate predictive factors impacting clinical outcomes.
  • Analyzed data from the Spanish TAVI registry with 46 participating centers since 2010.
  • Divided patients into three groups based on mean baseline gradients: very low grade (VLG), low grade (LG), and high grade (HG).
  • Compared baseline characteristics, all-cause mortality, and survival predictors among the three groups.
  • Among 17,421 patients, 12,800 were HG, 4,126 were LG, and 495 were VLG.
  • Two-year survival rates were 83% for HG, 79% for LG, and 74% for VLG, with a statistically significant difference (p<0.001).
  • Mortality risk significantly increased for LG (HR 1.18) and VLG (HR 1.6) compared to HG.
  • EuroSCORE II and STS scores were significant mortality predictors, particularly in the VLG group.

Structured PICO

Does baseline mean gradient (high, low, very low) affect 2-year survival and the predictive value of risk scores in patients undergoing TAVI?

P
Population
17,421 patients undergoing TAVI between 2010 and 2024 from the Spanish TAVI registry, divided into high gradient (HG, ≥ 40 mmHg, n=12,800), low gradient (LG, 20-40 mmHg, n=4,126), and very low gradient (VLG, ≤ 20 mmHg, n=495).
I
Intervention
Transcatheter Aortic Valve Implantation (TAVI) in patients with low (20-40 mmHg) or very low (≤ 20 mmHg) baseline mean gradient
C
Comparator
TAVI in patients with high baseline mean gradient (≥ 40 mmHg)
O
Outcome
All-cause mortality at 2 yearshard clinical

In TAVI patients, lower baseline gradients (especially ≤ 20 mmHg) are associated with increased 2-year mortality, though survival remains acceptable and conventional risk scores maintain their predictive value.

Cite This Study

Hernandez et al. (2025) studied this question. TAVI patients with very low gradient (≤20 mmHg) had higher 2-year mortality (74%) vs high gradient (83%), with HR 1.6; STS score and LVEF predicted mortality best in VLG.

synapsesocial.com/papers/698827e20fc35cd7a8846d8chttps://doi.org/10.1093/eurheartj/ehaf784.2372
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