Advanced stage Cardiac Damage Staging at 1-year post-TAVR was associated with higher all-cause mortality (adjusted HR 1.90; 95% CI 1.10-3.29; p=0.02).
Cohort (n=762)
No
Does the trajectory of Cardiac Damage Staging (CDS) at 1-year post-TAVR predict long-term all-cause mortality in patients undergoing TAVR?
Cardiac damage staging evolves during the first year post-TAVR, and having an advanced stage at 1-year is a significant predictor of long-term mortality.
Hazard Ratio: 1.9 (95% CI 1.1–3.29)
p-value: p=0.02
Cardiac Damage Staging (CDS) is associated with prognosis and may evolve after transcatheter aortic valve replacement (TAVR). However, the prognostic value of CDS at 1-year and the trajectory of CDS, and its underlying factors, remains unclear. From a single-center registry, patients who underwent TAVR between 2016 and 2023 and had echocardiographic assessment at baseline, immediately post-TAVR, and 1-year, were included. We evaluated (1) temporal changes in CDS, (2) factors associated with CDS evolution, and (3) the association between 1-year CDS and long-term survival. CDS was assessed using the original schema and dichotomized as early stage (stage 0–2) versus advanced stage (stage 3–4). Among 762 patients, 676 were classified as early stage and 86 as advanced stage at baseline. In the baseline early stage group, 25 (3.7%) worsened to advanced stage immediately post-TAVR, and 48 (7.1%) had worsened by 1-year. Among baseline advanced stage group, 39 (45.3%) improved to early stage immediately post-TAVR, increasing to 50 (58.1%) at 1-year. Absence of baseline atrial fibrillation (AF) was associated with CDS improvement, whereas baseline AF and mild tricuspid regurgitation (TR) were associated with CDS worsening. Advanced stage CDS at 1-year was associated with higher all-cause mortality (adjusted HR 1.90; 95% CI 1.10–3.29; p = 0.02). Among the baseline early stage group, worsening to advanced stage was associated with a two-fold higher mortality risk. CDS evolves during the first year post-TAVR and is influenced by AF and TR. CDS at 1-year after TAVR was associated with long-term survival. Graphical abstract Trajectories of Cardiac Damage Staging (CDS) After TAVR and Long-Term Outcomes
Yoshida et al. (2026) conducted a cohort in Transcatheter aortic valve replacement (TAVR) (n=762). Advanced stage Cardiac Damage Staging (CDS) at 1-year vs. Early stage CDS was evaluated on All-cause mortality (HR 1.90, 95% CI 1.10-3.29, p=0.02). Advanced stage Cardiac Damage Staging at 1-year post-TAVR was associated with higher all-cause mortality (adjusted HR 1.90; 95% CI 1.10-3.29; p=0.02).