Change in left ventricular ejection fraction after transcatheter aortic valve replacement in severe aortic stenosis

Abstract

Background: Long-standing aortic stenosis (AS) leads to elevated left ventricular (LV) pressure and as a consequence develops LV hypertrophy and increased myocardial fibrosis. The LV ejection fraction (LVEF) remains often preserved until the late stages of disease, but subtle LV dysfunction can be present in patients of severe AS. Transcatheter aortic valve replacement (TAVR) has become the primary method of aortic valve replacement for intermediate and high surgical risk patients with AS. In this study, we aimed to see if TAVR in patients with severe AS can result in the improvement of systolic functions. Subjects and Methods: We retrospectively studied the data of 52 consecutive symptomatic patients with severe symptomatic AS who underwent TAVR at our center. Echocardiography was performed at baseline and 6 months after the procedure to evaluate change in LVEF. Results: Fifty-two patients were retrospectively evaluated. The mean LVEF before TAVR was 49.52 ± 13.44. The mean LVEF after TAVR was 52.02 ± 10.95. That means there was a significant increase in LVEF after TAVR as compared to LVEF before TAVR (P = 0.008 using Wilcoxon signed-rank test). Conclusion: In this article, we conclude that, in AS patients, the removal of afterload by TAVR significantly improves cardiac functions as assessed by LVEF.

Keywords

• left ventricular ejection fraction
• transcatheter aortic valve replacement
• severe aortic stenosis