Left Ventricular End Diastolic Pressures are Associated with Six Month Mortality Rates following Transcatheter Aortic Valve Replacement

Background: Left ventricle end diastolic pressure (LVEDP) measured during cardiac catheterization is an independent predictor of prognosis in acute myocardial infarction. We evaluated the prognostic value of postprocedural LVEDP in a large cohort of severe aortic stenosis patients treated with transcatheter aortic valve Replacement (TAVR).

Methods: A cohort of 410 consecutive patients with severe aortic stenosis undergoing TAVI was divided into 2 groups according to postprocedural LVEDP above and below 10 mmHg. Collected data included patient characteristics, medical background, left ventricle ejection fraction (LVEF), frailty score, Society of Thoracic Surgeons (STS) score, periprocedural laboratory results and clinical outcomes.

Results: The mean age (±SD) was 83.1±6.1 years, mean STS score was 4.0±3.2% and mean estimated LVEF was 54.8±10.5%. Patients with LVEDP>10 mmHg (n=300) and LVEDP10 mmHg was independently associated with all-cause mortality (HR 2.04, 95% CI 1.03 to 57.2, p<0.05) after adjusting for all the above-mentioned variables.

Conclusions: Elevated LVEDP is a strong independent predictor of mortality following TAVR, and might present a potential guidance for postprocedural management.