Why the study?
Patients with severe symptomatic aortic stenosis and depressed LV function without significant myocardial scarring may derive maximum benefit and immediate improvement following LV afterload reduction after percutaneous valve replacement.
Does TAVR improve LV function in patients with severe symptomatic aortic stenosis and depressed LV function?
Does TAVR improve LV function in patients with severe symptomatic aortic stenosis and depressed LV function?
TAVR can lead to immediate recovery of depressed LV function in patients with severe symptomatic aortic stenosis without significant myocardial scarring.
Answers are grounded in this paper and cite their sources.
May support rapid LV recovery via afterload reduction in low-EF severe AS; leaves open predictors, durability, and need for prospective data.
Aortic stenosis (AS) is characterized by gradual thickening, fibrosis, and calcification leading to reduced opening of aortic valve leaflets. Aortic valve narrowing increases the afterload on left ventricle (LV), which consequently leads to hypertrophy and myocardial fibrosis which over a period of time leads to diastolic dysfunction. LV diastolic dysfunction is an independent predictor of heart failure rehospitalization and mortality in post-aortic valve replacement patients. Chronic pressure overload leads to development of systolic dysfunction due to afterload mismatch. Patients with severe symptomatic AS and depressed LV function without significant myocardial scarring will derive maximum benefit after percutaneous valve replacement and thus show immediate improvement after reduction of LV afterload. We report two such cases which had good LV function recovery immediately after transcatheter aortic valve replacement (TAVR).
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Arramraju et al. (2020) studied this question.
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