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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