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Objective <p>To assess changes in LV function, hemodynamics, and ventricular arrhythmias (VAs) after transcatheter aortic valve implantation (TAVI) in severe aortic stenosis (AS) patients at 1-month and 1-year follow-up.</p> Methods <p>Eighty severe AS patients undergoing TAVI were analyzed after exclusions (prior pacemaker, post-TAVI complications, death, or missing data). Echocardiography (left ventricular ejection fraction [LVEF], left ventricular end-diastolic diameter [LVEDD], mean transaortic gradient), NT-proBNP levels, and 24-h Holter monitoring (modified Lown grading for VAs) were evaluated pre-TAVI, at 1 month, and 1 year post-TAVI.</p> Results <p>At 1 month, LVEF improved from 41.5 ± 7.8% to 48.0 ± 6.0% (<i>P</i> = 0.034), LVEDD decreased from 56.6 ± 11.5&#xa0;mm to 54.0 ± 11.0&#xa0;mm (<i>P</i> = 0.020), and mean gradient dropped from 54.8 ± 9.5 mmHg to 18.2 ± 4.5 mmHg (<i>P</i> &lt; 0.001). NT-proBNP decreased from 3870 pg/mL (IQR: 780–26500) to 1015 pg/mL (IQR: 550–8500) (<i>P</i> &lt; 0.01). Lown grade 3–4 VAs declined from 33.8% to 17.5% (<i>P</i> = 0.030). At 1 year, LVEF further improved to 51.5 ± 5.5% (<i>P</i> &lt; 0.001), LVEDD to 52.5 ± 10.8&#xa0;mm (<i>P</i> &lt; 0.01), and mean gradient to 15.5 ± 4.0 mmHg (<i>P</i> &lt; 0.001). NT-proBNP remained low (850 pg/mL, IQR: 450–15500; <i>P</i> &lt; 0.001), and Lown 3–4 VAs decreased to 12.5% (<i>P</i> &lt; 0.001). Ventricular tachycardia incidence reduced from 12.5% pre-TAVI to 5.0% at 1 year (<i>P</i> = 0.016).</p> Conclusion <p>TAVI significantly improves LV function, promotes reverse remodeling, and reduces severe VAs in severe AS patients, with sustained benefits at 1 year, highlighting its positive impact on cardiac structure, function, and arrhythmic burden.</p>

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Transcatheter aortic valve implantation improves left ventricular function and hemodynamics and reduces severe ventricular arrhythmias in patients with severe aortic stenosis

  • 期刊论文

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  • 发表日期：

    2025年10月29日

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  • Jinghui An,
  • Huajun Wang,
  • Hongjuan Liao,
  • Fang Yan,
  • Fengwu Shi,
  • Su Liu

摘要

Objective

To assess changes in LV function, hemodynamics, and ventricular arrhythmias (VAs) after transcatheter aortic valve implantation (TAVI) in severe aortic stenosis (AS) patients at 1-month and 1-year follow-up.

Methods

Eighty severe AS patients undergoing TAVI were analyzed after exclusions (prior pacemaker, post-TAVI complications, death, or missing data). Echocardiography (left ventricular ejection fraction [LVEF], left ventricular end-diastolic diameter [LVEDD], mean transaortic gradient), NT-proBNP levels, and 24-h Holter monitoring (modified Lown grading for VAs) were evaluated pre-TAVI, at 1 month, and 1 year post-TAVI.

Results

At 1 month, LVEF improved from 41.5 ± 7.8% to 48.0 ± 6.0% (P = 0.034), LVEDD decreased from 56.6 ± 11.5 mm to 54.0 ± 11.0 mm (P = 0.020), and mean gradient dropped from 54.8 ± 9.5 mmHg to 18.2 ± 4.5 mmHg (P < 0.001). NT-proBNP decreased from 3870 pg/mL (IQR: 780–26500) to 1015 pg/mL (IQR: 550–8500) (P < 0.01). Lown grade 3–4 VAs declined from 33.8% to 17.5% (P = 0.030). At 1 year, LVEF further improved to 51.5 ± 5.5% (P < 0.001), LVEDD to 52.5 ± 10.8 mm (P < 0.01), and mean gradient to 15.5 ± 4.0 mmHg (P < 0.001). NT-proBNP remained low (850 pg/mL, IQR: 450–15500; P < 0.001), and Lown 3–4 VAs decreased to 12.5% (P < 0.001). Ventricular tachycardia incidence reduced from 12.5% pre-TAVI to 5.0% at 1 year (P = 0.016).

Conclusion

TAVI significantly improves LV function, promotes reverse remodeling, and reduces severe VAs in severe AS patients, with sustained benefits at 1 year, highlighting its positive impact on cardiac structure, function, and arrhythmic burden.