Impact of aortic valve calcification volume on left ventricular systolic function in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation

Abstract

Background

Aortic valve calcification (AVC) has been linked to negative cardiac outcomes in patients with aortic stenosis (AS). Given the limited understanding of its specific contributions, we aimed to investigate the interaction between AVC and the left ventricular (LV) systolic function in patients with severe AS and LV systolic dysfunction who underwent transcatheter aortic valve implantation (TAVI).

Materials and methods

An observational study of 75 patients with severe AS and LV ejection fraction (EF) ≤ 50 % who underwent TAVI. AVC volume was determined by ECG-gated contrast-enhanced multidetector computed tomography (MDCT) using specific software (3Mensio Structural Heart version 10.4, Pie Medical Imaging, Maastricht, the Netherlands). Patients were categorized into two groups based on LV systolic function recovery 30 days after TAVI defined by ≥10 % absolute increase in LVEF compared to baseline.

Results

AVC volume showed a statistically significant negative correlation with the baseline LVEF (r = −0.33, P = 0.008) and a statistically significant positive correlation with the percentage of change in LVEF as compared to the baseline (r = 0.38, P = 0.001). In the logistic regression for post-TAVI LV systolic function recovery, AVC volume was associated with an increased likelihood of LV systolic function recovery.

Conclusion

AVC volume has a paradoxical association with LV systolic function. Patients with a higher AVC volume had a more depressed baseline LV systolic function and a greater likelihood of LV systolic function recovery after TAVI.