Long-Term Impact of Cardiac Damage Following Transcatheter Aortic Valve Replacement.

Nakase, Masaaki; Tomii, Daijiro; Heg, Dik; Praz, Fabien; Stortecky, Stefan; Reineke, David; Samim, Daryoush; Lanz, Jonas; Windecker, Stephan; Pilgrim, Thomas (2024). Long-Term Impact of Cardiac Damage Following Transcatheter Aortic Valve Replacement. JACC. Cardiovascular Interventions, 17(8), pp. 992-1003. Elsevier 10.1016/j.jcin.2024.02.011

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Extravalvular cardiac damage caused by aortic stenosis affects prognosis after transcatheter aortic valve replacement (TAVR). The long-term impact of changes in cardiac damage in response to relief from mechanical obstruction has not been fully investigated.


The authors aimed to investigate changes in cardiac damage early after TAVR and the prognostic impact of the cardiac damage classification after TAVR.


In this single-center observational study, patients undergoing transfemoral TAVR were retrospectively evaluated for cardiac damage before and after TAVR and classified into 5 stages of cardiac damage (0-4).


Among 1,863 patients undergoing TAVR between January 2007 and June 2022, 56 patients (3.0%) were classified as stage 0, 225 (12.1%) as stage 1, 729 (39.1%) as stage 2, 388 (20.8%) as stage 3, and 465 (25.0%) as stage 4. Cardiac stage changed in 47.7% of patients (improved: 30.1% in stages 1-4 and deteriorated: 24.7% in stages 0-3) early after TAVR. Five-year all-cause mortality was associated with cardiac damage both at baseline (HRadjusted: 1.34; 95% CI: 1.24-1.44; P < 0.001 for linear trend) and after TAVR (HRadjusted: 1.40; 95% CI: 1.30-1.51; P < 0.001 for linear trend). Five-year all-cause mortality was stratified by changes in cardiac damage (improved, unchanged, or worsened) in patients with cardiac stage 2, 3, and 4 (log-rank P < 0.001 for stage 2, 0.005 for stage 3, and <0.001 for stage 4).


The extent of extra-aortic valve cardiac damage before and after TAVR and changes in cardiac stage early after TAVR have important prognostic implications during long-term follow-up. (SwissTAVI Registry; NCT01368250).

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Heart Surgery
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR)

UniBE Contributor:

Tomii, Daijiro, Heg, Dierik Hans, Praz, Fabien Daniel, Stortecky, Stefan, Reineke, David Christian, Samim, Daryoush, Lanz, Jonas, Windecker, Stephan, Pilgrim, Thomas


600 Technology > 610 Medicine & health








Pubmed Import

Date Deposited:

01 May 2024 09:16

Last Modified:

02 May 2024 06:35

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Uncontrolled Keywords:

aortic stenosis cardiac damage staging classification transcatheter aortic valve replacement





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