Valvular & structural heart disease
Left Ventricular Health and Transcatheter Aortic Valve Replacement (TAVR) Timing in Asymptomatic Severe Aortic Stenosis: Analysis From the EARLY TAVR Trial
Authors' conclusion
For patients with asymptomatic severe AS, the benefit of early TAVR, compared with CS, is consistent regardless of baseline LV health according to integrated or individual measures.
Study context
- Population
- Patients with asymptomatic severe aortic stenosis (AS)
- Participants
- 901 patients
- Comparison
- Early TAVR vs clinical surveillance, by baseline left ventricular (LV) health
- TAVRn = 455
- Clinical surveillance (CS)n = 446reference
Methodological detailsmulticentre, 75 centres in US and Canada, core laboratory echocardiography, exploratory effect-modification analyses
- Multicentre
- 75 centres in US and Canada
- Core laboratory echocardiography
- Exploratory effect-modification analyses
Primary result
As reported in the abstract
Benefit of early TAVR vs CS by baseline LV health
- Benefit of early TAVR vs CS consistently observed regardless of whether LV health (integrated and individual components) was normal or not
- Exploratory (LV health not prespecified as stratification variable)
Secondary outcomes
Normal integrated LV health (ITT) · 2 years · intention-to-treat · prespecified secondary endpoint · also less frequent for component measures with CS
P < 0.001
Normal integrated LV health at baseline (ITT) · randomization
- Normal integrated LV health
- 27%
- Normal LV mass index (LVMi)
- 64%
- Normal left atrial volume index (LAVi)
- 42%
- Normal global longitudinal strain (GLS)
- 88%
- Abnormal integrated LV health and each component generally associated with higher event rates across several composite endpoints
LV health in CS patients undergoing delayed AVR · randomization to preprocedure
- LV health tended to decline (all measures except GLS)
- P < 0.10
- Baseline LV health did not predict timing of conversion to AVR nor severity of presentation
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Left Ventricular Health and TAVR Timing in Asymptomatic Severe Aortic Stenosis: Analysis From the EARLY TAVR Trial. J Am Coll Cardiol. Published 7 September 2025. doi:10.
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