ArticleAnatolian journal of cardiology2025
Clinical Outcomes of Transcatheter Aortic Valve Replacement in Patients with Various Flow-Gradient and Ejection Fraction Profiles.
Article in Anatolian journal of cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Clarification Needed on Methodological Aspects of TAVR Outcomes Across Flow-Gradient and Ejection Fraction Profiles.Anatolian journal of cardiology · 2025Article
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9 authors.
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Abstract
backgroundTo compare the clinical outcomes of transcatheter aortic valve replace-ment (TAVR) for severe aortic stenosis (AS) in patients with different flow-gradient and left ventricular ejection fraction (EF) profiles.
methodsPatients with severe AS who underwent TAVR with newer generation valves (Sapien3/3 Ultra, Evolut Pro/Pro+/FX) were retrospectively analyzed. Patients were divided into 5 groups: normal-flow high-gradient (NF-HG) AS (stroke volume index ≥ 35 mL/m2 and mean pressure gradient ≥ 40 mm Hg), low-flow high-gradient (LF-HG) with preserved EF (pEF, ≥ 50%), LF-HG with reduced EF (rEF), low-flow low-gradient (LF-LG) with pEF, and LF-LG with rEF.
resultsA total of 846 patients were included in this study (NF-HG, n = 458; LF-HG with pEF, n = 142; LF-HG with rEF, n = 50; LF-LG with pEF, n = 113; LF-LG with rEF, n = 83). For the entire cohort, the median age was 82 years, and the periprocedural mortality rate was 2.1% with the highest rate in the LF-LG with rEF AS (7.2%). The 1-year and 5-year mortality rates were 13% and 51%, respectively. Multivariable Cox regression analysis showed higher all-cause mortality in the LF-HG with pEF (hazard ratio 1.42 [95% CI: 1.02-1.98]), LF-LG with pEF (1.84 [1.32-2.55]), and LF-LG with rEF (1.78 [1.22-2.61]) groups compared with the NF-HG group. Cardiovascular death rates were significantly higher in the LF-LG groups, but not in the LF-HG groups.
conclusionIn addition to both LF-LG with pEF and rEF AS, LF-HG with pEF AS had a higher all-cause mortality rate after TAVR compared to NF-HG AS.
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