Key result
Flow improvement post-TAVR in low-flow low-gradient AS shows no benefit for mortality or HF hospitalization.
Why the study?
Does flow improvement post-TAVR reduce mortality and heart failure rehospitalization in patients with low-flow low-gradient aortic stenosis?
Cohort (n=633)
Does flow improvement post-TAVR reduce mortality and heart failure rehospitalization in patients with low-flow low-gradient aortic stenosis?
Answers are grounded in this paper and cite their sources.
In patients with low-flow low-gradient aortic stenosis undergoing TAVR, flow improvement occurs in about one-third of patients but does not significantly impact mortality or heart failure rehospitalization.
Background: Flow is known to typically improve after transcatheter aortic valve replacement (TAVR); however, the characteristics correlating with improvement are still unclear. This study sought to explore the outcomes of patients with low-flow low-gradient aortic stenosis (LFLG AS) and flow improvement following TAVR compared to those without flow improvement, in addition to the predictors of flow improvement. Methods: were included. Patients were classified into 2 groups according to whether SVI improved by 20% or more at the 30-day follow-up. Patients who underwent valve-in-valve TAVR were excluded. Binary logistic regression was used to evaluate the predictors of flow improvement. Results: A total of 633 patients had LFLG AS. Two hundred twenty-eight patients (36%) had SVI improvement by 20% or more. Male sex, left ventricular ejection fraction (LVEF) improvement by 10% or more 30 days post-TAVR, lower baseline SVI and paradoxical LFLG AS predicted flow improvement. There was no difference in mortality and heart failure rehospitalization between patients with and without flow improvement. Conclusions: One-third of patients with LFLG AS show an improvement in flow post-TAVR. Paradoxical LFLG AS, male sex, lower baseline SVI, and improvement in LVEF correlated with flow improvement, whereas baseline LVEF did not. There was no difference in clinical outcomes between patients with and without flow improvement post-TAVR.
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Besir et al. (2025) conducted a cohort in Low-flow low-gradient aortic stenosis (n=633). Flow improvement (SVI improvement ≥20% at 30 days) vs. No flow improvement was evaluated on Mortality and heart failure rehospitalization. Flow improvement post-TAVR occurred in 36% of patients with low-flow low-gradient aortic stenosis, but showed no difference in mortality or heart failure rehospitalization between groups.
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