open access

Vol 22, No 1 (2015)
Original articles
Published online: 2015-02-24
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Impact of transcatheter aortic valve implantation in patients with reduced ejection fraction

Hüseyin Ayhan, Hacı Ahmet Kasapkara, Tahir Durmaz, Telat Keleş, Abdullah Nabi Aslan, Cenk Sarı, Serdal Baştuğ, Emine Bilen, Nihal Akar Bayram, Murat Akçay, Engin Bozkurt
DOI: 10.5603/CJ.a2014.0040
·
Pubmed: 24846516
·
Cardiol J 2015;22(1):108-114.

open access

Vol 22, No 1 (2015)
Original articles
Published online: 2015-02-24

Abstract

Background: Aortic stenosis increases with age. According to guidelines, left ventricular systolic dysfunction is an indication for aortic valve replacement, even in asymptomatic patients. There is no clear data on the application of transcatheter aortic valve implantation (TAVI), which is a method showing continuous improvement in recent years, in patients with reduced ejection fraction (REF) having a poor prognosis for surgical aortic valve replacement. We therefore aimed to investigate the effect of TAVI on left ventricular ejection fraction (LVEF) and also its efficacy and safety in patients with REF.

Methods and results: The study included 104 patients who underwent transfemoral TAVI in our clinic. The patients were divided into two groups: LVEF ≤ 45% (REF group, n = 28) and LVEF > 45% (preserved ejection fraction [PEF] group, n = 76). Follow-up measure­ments were performed at baseline, discharge, 1st, 6th and 12th months. No statistical difference was found between the groups with respect to complications and mortality rates. A statistically significant difference was detected in LVEF after TAVI, either in all patients (53.9 ± 14.6, 57.0 ± 11.4, 59.4 ± 8.4, 60.4 ± 6.8, 63.2 ± 3.9, respectively, at baseline, discharge, 1st, 6th and 12th months, p < 0.001) or in the groups separately. A statistically significant increase in LVEF (p < 0.001) was determined at discharge, 1st, 6th and 12th months, whereas LVEF increased in all follow-ups of the PEF group, however this elevation reached a statistical significance only at the 1st month (p = 0.04).

Conclusions: Our study has shown the positive effect of TAVI on LVEF and its effective and safe applicability in patients with REF.

Abstract

Background: Aortic stenosis increases with age. According to guidelines, left ventricular systolic dysfunction is an indication for aortic valve replacement, even in asymptomatic patients. There is no clear data on the application of transcatheter aortic valve implantation (TAVI), which is a method showing continuous improvement in recent years, in patients with reduced ejection fraction (REF) having a poor prognosis for surgical aortic valve replacement. We therefore aimed to investigate the effect of TAVI on left ventricular ejection fraction (LVEF) and also its efficacy and safety in patients with REF.

Methods and results: The study included 104 patients who underwent transfemoral TAVI in our clinic. The patients were divided into two groups: LVEF ≤ 45% (REF group, n = 28) and LVEF > 45% (preserved ejection fraction [PEF] group, n = 76). Follow-up measure­ments were performed at baseline, discharge, 1st, 6th and 12th months. No statistical difference was found between the groups with respect to complications and mortality rates. A statistically significant difference was detected in LVEF after TAVI, either in all patients (53.9 ± 14.6, 57.0 ± 11.4, 59.4 ± 8.4, 60.4 ± 6.8, 63.2 ± 3.9, respectively, at baseline, discharge, 1st, 6th and 12th months, p < 0.001) or in the groups separately. A statistically significant increase in LVEF (p < 0.001) was determined at discharge, 1st, 6th and 12th months, whereas LVEF increased in all follow-ups of the PEF group, however this elevation reached a statistical significance only at the 1st month (p = 0.04).

Conclusions: Our study has shown the positive effect of TAVI on LVEF and its effective and safe applicability in patients with REF.

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Keywords

transcatheter aortic valve implantation, reduced ejection fraction, heart failure

About this article
Title

Impact of transcatheter aortic valve implantation in patients with reduced ejection fraction

Journal

Cardiology Journal

Issue

Vol 22, No 1 (2015)

Pages

108-114

Published online

2015-02-24

DOI

10.5603/CJ.a2014.0040

Pubmed

24846516

Bibliographic record

Cardiol J 2015;22(1):108-114.

Keywords

transcatheter aortic valve implantation
reduced ejection fraction
heart failure

Authors

Hüseyin Ayhan
Hacı Ahmet Kasapkara
Tahir Durmaz
Telat Keleş
Abdullah Nabi Aslan
Cenk Sarı
Serdal Baştuğ
Emine Bilen
Nihal Akar Bayram
Murat Akçay
Engin Bozkurt

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