Abstract| Volume 23, ISSUE 10, SUPPLEMENT , S22, October 2017

Worsening Heart Failure after Transcatheter Aortic Valve Implantation in Patients with Severe Aortic Stenosis

      Background: Worsening heart failure (WHF) after transcatheter aortic valve implantation (TAVI) is occasionally observed. The aim of this study was to determine the characteristics of the patients who worsened HF after TAVI. Methods: A total of 44 patients with symptomatic severe aortic stenosis (AS) who underwent TAVI (age: 85 ± 5years) were included for this study. All patients were performed transthoracic echocardiography before and 1 week after TAVI. WHF was defined as a case of unplanned re-hospitalization or required treatment intensification for HF later than 1 month after the procedure. We clarified the association between WHF and clinical and echocardiographic parameters. Results: Ten patients had experienced WHF after TAVI. Baseline characteristics such as HF severity, BNP level, operative risk score and comorbidities were similar between the two groups. Compared to non-WHF patients, those with WHF were older (84 ± 5 vs. 88 ± 5years, P < .05), high E/A ratio (0.7 ± 0.3 vs. 1.1 ± 0.6, P < .05), and lower trans-aortic velocity and pressure gradient before TAVI (5.1 ± 0.6 vs. 4.6 ± 0.6m/sec, 62 ± 16 vs. 49 ± 14 mmHg, respectively, P < .05). In addition, changes in left atrial (LA) longitudinal strain value before and 1week after TAVI were lower in WHF patients compared to non-WHF patients (−1.5 ± 2.1 vs. 3.1 ± 4.3%, P < .01). Conclusions: WHF was observed in one out of five patients later than 1 month after TAVI, and was associated with LV diastolic function and changes in LA function.
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