Left ventricular ejection fraction and early heart failure after transcatheter aortic valve implantation

Background

Transcatheter aortic valve implantation (TAVI) is widely used in elderly patients with severe aortic stenosis and a high burden of comorbidities. The role of baseline left ventricular ejection fraction (LVEF) in predicting early heart failure (HF) after TAVI in real-world populations remains uncertain.

Purpose

To evaluate the association between baseline LVEF and early HF occurrence following TAVI.

Methods

We performed a retrospective single-center analysis of consecutive patients undergoing TAVI. Baseline demographic, clinical and echocardiographic data were collected. LVEF was categorized as <50% or ≥50%. Early HF was defined as clinically documented HF during the index hospitalization. Logistic regression analysis was used to assess the association between LVEF and early HF, adjusting for age. Results are presented as odds ratios (OR) with 95% confidence intervals (CI).

Results

A total of 188 patients were included (mean age 81 ± 7 years, 52% female). Most patients had preserved LVEF at baseline, while a smaller proportion presented with LVEF <50%. Early HF occurred in a limited number of patients.

Patients with LVEF <50% showed a numerically higher risk of early HF compared with those with preserved LVEF. In age-adjusted logistic regression analysis, LVEF <50% was associated with increased odds of early HF (OR 1.97, 95% CI 0.35–11.07; p = 0.44). Age was not independently associated with early HF (OR per year 1.04, 95% CI 0.92–1.17; p = 0.55). Confidence intervals were wide, reflecting the low number of HF events.

Conclusions

In this real-world TAVI cohort, baseline LVEF <50% was associated with a numerically higher risk of early HF, although this did not reach statistical significance. These findings suggest that LVEF alone may be insufficient to identify patients at risk of early HF after TAVI, highlighting the need for integrated clinical risk assessment.