Myocardial Work Indices Predict Survival Post TAVI in Aortic Stenosis Patients

TL;DR

This study shows that certain heart function measurements before a TAVI procedure can predict survival in aortic stenosis patients.

Contribution

The study identifies optimal cut-off values for LVMW indices to stratify patient risk post-TAVI.

Findings

Median survival after TAVI was 1404 days with 29% all-cause mortality during follow-up.

EF, GLS, GWI, GWE, and GCW were independent predictors of mortality in multivariate analysis.

Cut-off values for GCW, GWI, and GWE effectively stratified patients by survival risk.

Abstract

Background: Left Ventricle Myocardial Work (LVMW) has shown utility in assessing patients with aortic stenosis (AS) in recent studies. In the present study, we evaluated the predictive value and optimal cut-off values of LVMW parameters measured prior to TAVI that may be associated with increased mortality in AS patients. Methods: A total of 116 consecutive patients who were qualified for TAVI between March 2021 and November 2022 were evaluated. Pre-procedural LVMW indices (GWI, GCW, GWW, and GWE) were assessed and long-term survival was analysed. Survival and influencing factors were evaluated using univariate and multivariate Cox proportional hazard models, with significant factors subsequently included in cut-off analysis. Results: The median survival time following the TAVI procedure was 1404 (1143–1549) days, with a maximum observation period of 1721 days. All-cause mortality during the follow-up period reached 29%. Multivariate analysis revealed that EF, GLS, GWI, GWE and GCW before TAVI were independent predictors of all-cause mortality. We identified 1975 mmHg, 1497 mmHg and 85% as optimal cut-off values for GCW, GWI and GWE, which allow for significant stratification of patients according to risk. Conclusions: In this analysis, baseline-assessed parameters such as GLS, GWI, GWE, and GCW emerged as independent predictors of all-cause mortality. The proposed cut-off values clearly separated patient groups with different survival outcomes.

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