Key result
TAVI linked to ~47% reduction in moderate-to-severe MR without improving mortality or hospitalization.
Why the study?
Moderate to severe mitral regurgitation and tricuspid regurgitation are common in patients undergoing TAVI, but their course, impact on pulmonary hypertension, and effect on reverse remodeling require evaluation.
Does Transcatheter Aortic Valve Implantation (TAVI) improve functional mitral and tricuspid regurgitation and impact 2-year mortality or hospitalization in patients with aortic stenosis?
Observational (n=79)
No
Does Transcatheter Aortic Valve Implantation (TAVI) improve functional mitral and tricuspid regurgitation and impact 2-year mortality or hospitalization in patients with aortic stenosis?
Absolute Event Rate: 22.7% vs 43%
p-value: p=<0.05
TAVI significantly reduces the severity of functional mitral and tricuspid regurgitation, but this echocardiographic improvement does not translate to reduced 2-year mortality or hospitalization.
MR reduction after TAVI should not yet change practice; leaves open its prognostic value in larger prospective cohorts.
OBJECTIVE: Moderate to severe mitral regurgitation (MR) and tricuspid regurgitation (TR) are present in approximately 20-60% of patients undergoing transcatheter aortic valve implantation (TAVI). This study aims to evaluate the impact of TAVI on MR and TR, pulmonary hypertension, and reverse cardiac remodeling in these patients. Methods: Out of 240 patients who underwent TAVI, 79 who met the inclusion and exclusion criteria were analyzed. RESULTS: In our study, 46.8% (n = 37) of the patients were male. Nineteen (24.1%) patients died within two years. Before TAVI, 34 (43%) patients had moderate-to-severe MR, which decreased to 18 (22.7%) after the procedure (P < 0.05). Similarly, the number of patients with moderate-to-severe TR decreased from 26 (32.9%) before TAVI to 12 (15%) after the procedure (P < 0.05). Of the patients, 50.6% (n = 40) did not require hospitalization after the procedure, while 25 were hospitalized once, 12 twice, and 2 three times. The mean systolic pulmonary artery pressure (sPAP) values of the patients decreased from 44.30 ± 14.42 mmHg before the procedure to 39.09 ± 11.77 mmHg after the procedure (Z=-3.506, P < 0.001). No correlation was found between changes in MR and TR grades after TAVI and mortality or hospitalization during follow-up. Furthermore, there was no statistically significant difference in tricuspid annular plane systolic excursion (TAPSE), free wall annular S' velocity, left atrial volume (LAV), or LAV index (LAVI) before and after TAVI. Conclusion: There was a significant decrease in moderate-to-severe MR and TR after TAVI; however, this did not impact hospitalization or mortality rates. Additionally, no significant differences were observed in right ventricular systolic function or in LAV and LAVI before and after TAVI.
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Samir Adıgözelzade (2024) conducted an observational in Aortic Stenosis (n=79). Transcatheter Aortic Valve Implantation (TAVI) vs. Pre-TAVI (baseline) was evaluated on Moderate-to-severe mitral regurgitation (p=<0.05). Transcatheter aortic valve implantation significantly reduced moderate-to-severe mitral regurgitation from 43% to 22.7%, but this did not impact 2-year mortality or hospitalization rates.
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