Changes of Right Ventricular Function After Transcatheter Aortic Valve Replacement and Association With Outcomes

Felix Poch, Ruth Thalmann, Ida Olbrich, Carmen Fellner, Anja Stundl, Petra Barthel, Christian Bradaric, Karl Ludwig Laugwitz, Christian Kupatt, Jakob Ledwoch

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: Baseline right ventricular (RV) dysfunction represents a predictor for poor outcome in patients undergoing transcatheter aortic valve replacement (TAVR). However, RV function may improve after TAVR, which could have important implications on outcomes. The aim of the present study was to assess changes in RV function after TAVR and its prognostic value regarding clinical outcome. Methods and Results: Patients undergoing TAVR at our institution were consecutively enrolled and categorized into 4 groups according to changes in RV function during echocardiographic follow-up at 6 months. A total of 188 patients were included. Of those showing normal function at baseline, 87% (130/149) had preserved RV function at follow-up (group 1), whereas 13% (19/149) developed new RV dysfunction (group 2). Of those with RV dysfunction at baseline (39 patients), RV function normalized in 46% (18/39) (group 3) and remained impaired in 54% (21/39) (group 4). The Kaplan–Meier estimated survival at 3 years was highest in patients in group 1 (83%), intermediate in group 2 (65%) and 3 (69%), whereas group 4 had the worst survival (37%; P < .001). Furthermore, new or persistent RV dysfunction was identified to be independently associated with mortality during follow-up (hazard ratio 2.55; interquartile range 1.03–6.47, P = .004). Conclusions: Patients with preserved RV function have a high 3-year survival. Normalization of RV function showed improved survival compared with patients with persistent RV dysfunction, who had a dismal prognosis despite TAVR.

Original languageEnglish
Pages (from-to)1337-1344
Number of pages8
JournalJournal of Cardiac Failure
Volume27
Issue number12
DOIs
StatePublished - Dec 2021
Externally publishedYes

Keywords

  • RV function
  • Survival
  • TAVR

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