Key result
TAVI normalizes elevated systemic inflammation in patients with reduced LVEF by 6 months.
Why the study?
While the safety and efficacy of TAVI in patients with reduced LV function have been proven, the periprocedural inflammatory responses after TAVI in this population required investigation.
Does reduced versus preserved left ventricular function impact the kinetic behavior of systemic inflammatory markers in patients undergoing TAVI?
Cohort (n=156)
No
Does reduced versus preserved left ventricular function impact the kinetic behavior of systemic inflammatory markers in patients undergoing TAVI?
Absolute Event Rate: 3.3% vs 2.94%
p-value: p=0.288
TAVI is associated with a normalization of the inflammatory profile in patients with reduced LV function, which may account for some of the observable clinical benefits of the procedure in this population.
TAVI may normalize inflammation in reduced LV function; leaves open causal impact on outcomes or need for adjunctive therapies.
Background: Prior studies have proven the safety and efficacy of transcatheter aortic valve implantation (TAVI) in patients with reduced left ventricular (LV) function. This study’s aim was to investigate periprocedural inflammatory responses after TAVI. Methods: Patients with severe symptomatic aortic stenosis and reduced LV function who underwent transfemoral TAVI were enrolled. A paired-matched analysis (1:2 ratio) was performed using patients with preserved LV function. Whole white blood cells (WBC) and subpopulation dynamics as well as the neutrophil to lymphocyte ratio (NLR) were evaluated at different times. Results: A total of 156 patients were enrolled, including 52 patients with LVEF < 40% 35.00 [30.00, 39.25] and 104 with LVEF > 50% 55.00 [53.75, 60.0], p < 0.001. Baseline NLR in the reduced LV function group was significantly higher compared to the preserved LV function group, 2.85 [2.07, 4.78] vs. 3.90 [2.67, 5.26], p < 0.04. After a six-month follow-up, the inflammatory profile was found to be similar in the two groups, NLR 2.94 [2.01, 388] vs. 3.30 [2.06, 5.35], p = 0.288. No significant mortality differences between the two groups were observed in the long-term outcome. Conclusions: TAVI for severe symptomatic aortic stenosis, with reduced LV function, was associated with an improvement in the inflammatory profile that may account for some of the observable benefits of the procedure in this subset of patients.
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Khadija et al. (2021) conducted a cohort in Severe symptomatic aortic stenosis undergoing TAVI (n=156). Reduced left ventricular function (LVEF < 40%) vs. Preserved left ventricular function (LVEF > 50%) was evaluated on Neutrophil to lymphocyte ratio (NLR) at 6 months post-TAVI (p=0.288). In patients undergoing TAVI, those with reduced LV function had a higher baseline inflammatory profile that improved to levels similar to patients with preserved LV function at 6 months (NLR 3.30 vs 2.94, p=0.288).
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