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<p>Right ventricular dysfunction is a known predictor of early mortality after TAVI. TAPSE is a practical echocardiographic index of RV function. To assess whether baseline TAPSE predicts 30-day mortality after TAVI in a real-world cohort. Among 21 patients, those with TAPSE &lt; 17&#xa0;mm had higher 30-day mortality (28.6% vs 7.1%). PASP was higher in the low-TAPSE group (45 ± 12 vs 32 ± 10&#xa0;mmHg; <i>p</i> = 0.03). Non-survivors had a lower TAPSE/PASP ratio than survivors (median 0.351 [IQR 0.288–0.419] vs 0.607 [0.406–0.667]; exact p = 0.078), in line with a trend toward worse RV–pulmonary arterial coupling. A multivariable model including TAPSE, age, and EuroSCORE II showed apparent perfect discrimination (AUC = 1.00) within this very small dataset (3 events), likely overestimating true performance due to overfitting. TAPSE may serve as a simple, effective tool for early risk stratification in TAVI candidates as an adjunct to—rather than a replacement for—comprehensive geriatric/frailty assessment and established risk scores; estimates are unstable due to the small sample and event count.</p>

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Prognostic impact of right ventricular dysfunction in patients with severe aortic stenosis treated with trans-catheter aortic valve implantation: comment and validation from a small real-world cohort

  • 期刊论文

  • 发表日期：

    2025年9月29日

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  • Kaiyuan Cen,
  • Juanyu Lin,
  • Shixiang Yu

摘要

Right ventricular dysfunction is a known predictor of early mortality after TAVI. TAPSE is a practical echocardiographic index of RV function. To assess whether baseline TAPSE predicts 30-day mortality after TAVI in a real-world cohort. Among 21 patients, those with TAPSE < 17 mm had higher 30-day mortality (28.6% vs 7.1%). PASP was higher in the low-TAPSE group (45 ± 12 vs 32 ± 10 mmHg; p = 0.03). Non-survivors had a lower TAPSE/PASP ratio than survivors (median 0.351 [IQR 0.288–0.419] vs 0.607 [0.406–0.667]; exact p = 0.078), in line with a trend toward worse RV–pulmonary arterial coupling. A multivariable model including TAPSE, age, and EuroSCORE II showed apparent perfect discrimination (AUC = 1.00) within this very small dataset (3 events), likely overestimating true performance due to overfitting. TAPSE may serve as a simple, effective tool for early risk stratification in TAVI candidates as an adjunct to—rather than a replacement for—comprehensive geriatric/frailty assessment and established risk scores; estimates are unstable due to the small sample and event count.