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April 1, 2026European Heart Journal Supplements

Pre-TAVI echo staging of cardiac damage stratifies one-year mortality, reaching ~21% in the highest stage.

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Why the study?

The extent of cardiac damage in aortic stenosis is linked to worse outcomes, but its incidence, temporal changes, and clinical impact after TAVI required evaluation.

Does preprocedural echocardiographic staging of cardiac damage predict 1-year mortality in patients with severe symptomatic aortic stenosis undergoing TAVI?

Population

596 patients with severe symptomatic native AS undergoing TAVI with baseline cardiac damage assessed

Comparison

Cardiac damage stages 0 to 4 assessed by preprocedural TTE

Design

Post-hoc sub-analysis of a multicentre randomized trial

Follow-up

1 year

Key result

Preprocedural echocardiographic staging of cardiac damage in patients undergoing TAVI stratified one-year mortality, increasing progressively from 0% in stage 0 to 21.2% in stage 4.

Authors

YOY OnumaATA TobeMGM. Gallazzi

Discussion

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Overview

Facilitates pre-TAVI risk counseling and surveillance; extends cardiac damage staging validation to baseline assessment.

Key Points

  • This study aims to assess the relationship between cardiac damage stages and 1-year clinical outcomes in patients undergoing TAVI for severe aortic stenosis.
  • Post-hoc sub-analysis of the LANDMARK trial involving 768 patients with severe symptomatic aortic stenosis.
  • Patients categorized into 5 stages of cardiac damage based on transthoracic echocardiography (TTE) before procedure.
  • Follow-up assessments conducted at 1 year for mortality and composite endpoints.
  • Patients in stage 4 had the highest 1-year mortality at 21.2%, compared to lower mortality rates in stages 0 to 3.
  • The composite endpoint occurred in 25.3% of stage 4 patients, highlighting higher risks associated with advanced cardiac damage stages.
  • Improvement in cardiac damage stages was observed in 28.8% of patients at 1-year follow-up.

Structured PICO

Does preprocedural echocardiographic staging of cardiac damage predict 1-year mortality in patients with severe symptomatic aortic stenosis undergoing TAVI?

P
Population
596 patients with severe symptomatic native aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) and had preprocedural baseline cardiac damage assessed by transthoracic echocardiography.
I
Intervention
Preprocedural staging of cardiac damage (stages 0-4) by transthoracic echocardiography
O
Outcome
All-cause mortality at 1 yearhard clinical

Preprocedural echocardiographic staging of cardiac damage strongly stratifies 1-year mortality risk in patients undergoing TAVI for severe aortic stenosis, with stage 4 damage associated with over 20% mortality.

Cite This Study

Onuma et al. (2026) studied this question. Preprocedural echocardiographic staging of cardiac damage in patients undergoing TAVI stratified one-year mortality, increasing progressively from 0% in stage 0 to 21.2% in stage 4.

synapsesocial.com/papers/69ccb72e16edfba7beb8904ehttps://doi.org/10.1093/eurheartjsupp/suag056.070
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