Echocardiographic predictors of left ventricular ejection fraction improvement after transcatheter aortic valve replacement.

IF 1.1 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Echocardiography Pub Date : 2026-10-21 DOI:10.1007/s12574-026-00753-y

Shin Sato, Akiko Kumagai, Kai Ninomiya, Akiko Murofushi, Kaho Shimada, Michiko Yoshizawa, Ryo Ninomiya, Tetsuya Fusazaki, Yoshihiro Morino

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引用次数: 0

Abstract

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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来源期刊

Journal of Echocardiography CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.00

自引率

6.20%

发文量

期刊介绍： The Journal of Echocardiography, the official journal of the Japanese Society of Echocardiography, publishes work that contributes to progress in the field and articles in clinical research as well, seeking to develop a new focus and new perspectives for all who are concerned with this discipline. The journal welcomes original investigations, review articles, letters to the editor, editorials, and case image in cardiovascular ultrasound, which will be reviewed by the editorial board. The Journal of Echocardiography provides the best of up-to-date information from around the world, presenting readers with high-impact, original work focusing on pivotal issues.