Valvular & structural heart diseaseMeta-analysis
Impact of advanced cardiac damage in severe aortic stenosis on short-term and mid-term mortality and rehospitalisation after transcatheter aortic valve implantation: a systematic review and meta-analysis
- systematic review and meta-analysis
- random-effects meta-analysis
- meta-regression
Authors' conclusion
Extravalvular cardiac damage, especially RVD (stage 4), is strongly associated with increased short-term and mid-term mortality and rehospitalisation after TAVI. Even borderline-stage patients face elevated risk, underscoring the continuous nature of AS-related cardiac injury. Incorporating cardiac damage staging into preprocedural assessment can enhance risk stratification and guide management to improve patient outcomes.
Study context
- Population
- Adults with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), stratified by presence of right ventricular dysfunction (RVD), pulmonary hypertension (PH) or tricuspid regurgitation (TR)
- Participants
- 26,076 adults · 34 studies
- Comparison
- Outcomes after TAVI stratified by the presence of RVD, PH or TR
Pooled result
As reported in the abstract
All-cause mortality · Twelve-month
Hazard ratio (CI)
borderline stage
1.61(1.22–2.12)
stage 3
2.06(1.63–2.60)
stage 4
2.77(2.11–3.64)
Further pooled results
Cardiovascular mortality
| Comparison | Estimate | |
|---|---|---|
| stage 4 | HR 3.13 (CI 1.20–8.17) | |
| stage 4 | RR 2.63 (CI 1.54–4.47) | |
| 0.10.31310Ratio (log scale) |
Rehospitalisation
| Comparison | RR (CI) | |
|---|---|---|
| stage 3 · Rehospitalisation data were limited | 1.33 (1.12–1.58) | |
| 0.512Relative risk (log scale) |
Meta-regression of between-study heterogeneity
- age, sex and comorbidities contributed to between-study heterogeneity, particularly in stage 3 analyses
Original publication
Impact of advanced cardiac damage in severe aortic stenosis on short-term and mid-term mortality and rehospitalisation after transcatheter aortic valve implantation: a systematic review and meta-analysis. Heart. Published 6 March 2026. doi:10.1136/heartjnl-2025-326941
Summarised from the published abstract; every number is checked against it