Early reverse remodeling and long-term mortality predictors after transcatheter aortic valve implantation in severe symptomatic aortic stenosis

Abstract Background In patients with aortic stenosis (AS), left ventricular (LV) remodeling is a complex process involving both structural and functional abnormalities due to increased pressure afterload. Evidence remains limited not only regarding early LV reverse remodeling post-TAVI, but also its potential prognostic significance. Purpose To assess: (1) early effect of TAVI on LV ejection fraction (LVEF), LV mass, and diastolic function; (2) relationship between age, sex, NYHA class, comorbidities (diabetes mellitus - DM, hypertension - HTN, coronary artery disease - CAD, chronic kidney disease - CKD), and changes in LVEF, LV mass, and diastolic function; (3) association between early echocardiographic changes and all-cause mortality, during long-term follow-up. Methods Transthoracic echocardiography was performed prior to TAVI and before hospital discharge (5 ± 4 days), in patients with severe symptomatic AS who underwent successful TAVI. LVEF was assessed by Simpson's method, LV mass by Devereux method, and diastolic function by E/A ratio and left atrial (LA) diameter. Patients were followed up to 7 years (mean 4.1±1.9 years) post-procedure for all-cause mortality. Results 147 patients (77.5±5.1 years, 51.1% women) were analyzed. At admission 73 patients (49.7%) were classified in NYHA class III and IV. LVEF improved from 52.5±11.5 to 54.9±10.7% (p