Key result
Higher baseline E/e' is linked to ~10% higher odds of LVEF improvement after TAVR.
Why the study?
Do baseline echocardiographic parameters predict left ventricular ejection fraction improvement within 3 months after transcatheter aortic valve replacement in patients with severe aortic stenosis and baseline LVEF < 50%?
Observational (n=128)
Do baseline echocardiographic parameters predict left ventricular ejection fraction improvement within 3 months after transcatheter aortic valve replacement in patients with severe aortic stenosis and baseline LVEF < 50%?
Odds Ratio: 1.1 (95% CI 1.03–1.18)
p-value: p=<0.01
In patients with severe aortic stenosis and reduced LVEF undergoing TAVR, echocardiographic markers of pressure overload (higher LVMI, smaller AVA) and diastolic dysfunction (higher E/e′) predict LVEF recovery, which is associated with improved 1-year survival.
Background Improvement in left ventricular ejection fraction (LVEF) after transcatheter aortic valve replacement (TAVR) has been associated with better clinical outcomes, but predictors of recovery remain poorly defined. This study aimed to identify echocardiographic parameters associated with post-TAVR LVEF improvement in patients with severe aortic stenosis (AS) and reduced LVEF. Methods Among 1,133 consecutive patients who underwent TAVR between December 2013 and June 2024, 128 with baseline LVEF < 50% and follow-up echocardiography within 3 months were analyzed. LVEF improvement was defined as an absolute increase ≥ 10%. Independent predictors were identified using multivariable logistic regression. Post-procedural outcomes were assessed using Kaplan-Meier analysis. Results LVEF improvement occurred in 64 patients (50%). Multivariable analysis identified higher left ventricular mass index (LVMI) (OR 1.02, 95% CI 1.00-1.03, P = 0.01) and higher E/e′ (OR 1.10, 95% CI 1.03–1.18, P < 0.01) as independent predictors of improvement, whereas larger left ventricular end-diastolic volume (LVEDV) (OR 0.98, P = 0.01) and larger AVA (OR 0.67 per 0.1 cm², P < 0.01) were inversely associated. Patients with LVEF improvement had significantly lower 1-year all-cause mortality (98.2% vs. 87.0%, P = 0.01). Conclusions Echocardiographic parameters reflecting pressure overload and diastolic dysfunction predict LVEF recovery after TAVR. Postoperative LVEF improvement was associated with better 1-year survival, underscoring its prognostic value.
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Sato et al. (2026) conducted an observational in Severe aortic stenosis with reduced LVEF (<50%) undergoing TAVR (n=128). Baseline echocardiographic parameters (higher LVMI and E/e') vs. Lower LVMI, lower E/e', larger LVEDV, and larger AVA was evaluated on LVEF improvement (defined as an absolute increase ≥ 10% within 3 months post-TAVR) (OR 1.10, 95% CI 1.03-1.18, p=<0.01). Higher baseline E/e' (OR 1.10; 95% CI 1.03-1.18; P<0.01) and LVMI (OR 1.02; P=0.01) independently predicted LVEF improvement (≥10%) after TAVR, which occurred in 50% of patients.
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