J Echocardiogr. 2025 Nov 29. doi: 10.1007/s12574-025-00713-y. Online ahead of print.
ABSTRACT
BACKGROUND: Transvalvular flow rate (FR), defined as stroke volume divided by ejection time, is an important prognostic parameter in transcatheter aortic valve replacement (TAVR) patients. The prognostic implications of post-TAVR FR remain unclear, particularly in non-Western populations. We investigated the prognostic relevance of FR after TAVR in a Japanese population.
METHODS: We retrospectively analyzed 499 consecutive patients with severe aortic stenosis (AS) who underwent TAVR between 2014 and 2022. Patients were classified into three groups based on pre- and post-TAVR FR measured with transthoracic echocardiography: Normal FR (pre-FR ≥ 200 mL/s, N = 253), Recovered FR (pre-FR < 200 and post-FR ≥ 200, N = 112), and Persistently low FR (pre-FR < 200 and post-FR < 200, N = 134) group. All cause death- and heart failure (HF) readmission-free survival rate after TAVR were compared among the groups.
RESULTS: The mean age and BSA of participants were 84.1 ± 5.0 years and 1.45 ± 0.17 m2, and 64% were female. Thirty-eight all-cause deaths and 35 HF readmissions occurred within 2 years after TAVR. Patients in the Persistently low FR group had significantly more HF readmission than those in the Normal FR or Recovered FR groups (Log rank P < 0.001), whereas the all-cause death-free survival rate was similar among the three groups. Cox-Hazard multivariate analysis demonstrated that atrial fibrillation, chronic kidney disease, anemia, and persistently low FR were independent predictors of future HF readmission after TAVR (hazard ratio of persistently low FR = 2.38, P = 0.047).
CONCLUSION: AS patients with persistently low FR even after TAVR had a higher rate of HF hospital-readmissions in a Japanese cohort.
PMID:41317271 | DOI:10.1007/s12574-025-00713-y