Valvular & structural heart disease
Multimodal Atrial Cardiomyopathy Phenotypes for Risk Stratification in Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation (TAVI)
Authors' conclusion
Structural, functional, and electrical AtCM represent complementary domains with distinct prognostic implications in AS patients undergoing TAVI. Their integration may refine post-TAVI risk stratification; these exploratory findings require external validation before clinical management can be guided by AtCM phenotype.Keywords: Atrial cardiomyopathy; Aortic stenosis; TAVI; Left atrial strain; Heart failure; Atrial fibrillation
Study context
- Population
- Patients with severe aortic stenosis (AS), preserved left ventricular ejection fraction (LVEF), and sinus rhythm undergoing TAVI, without prior atrial fibrillation (AF)
- Participants
- 122 consecutive patients
- Exposure
- Multimodal markers of atrial cardiomyopathy (AtCM) (Echo-AtCM Risk and ECG-AtCM Risk) and their combined phenotypes for adverse outcomes after TAVI
- Outcome
- Baseline characteristics
Methodological detailsconsecutive patients, multivariable Cox regression analyses
- Consecutive patients
- Multivariable Cox regression analyses
Main finding
As reported in the abstract
Mean age
82.3±5.6 years
High Echo-Risk present
54.1%
High ECG-Risk present
19.7%
Observational data: associations, not effects.
Further findings
| Outcome | HR | P value |
|---|---|---|
| Death/HF hospitalizationIndependently predicted | 4.17 | P = 0.008 |
| Incident AFIndependently predicted | 3.07 | P = 0.034 |
| Combined profiling phenotypesHigh Echo/Low ECG · predicted HF/death | 4.86 | P = 0.008 |
| Combined profiling phenotypesLow Echo/High ECG · predicted AF | 8.99 | P = 0.004 |
| Combined profiling phenotypesHigh Echo/High ECG · conferred the worst prognosis | 6.23 | P = 0.015 |
Composite endpoint of all-cause mortality or heart failure (HF) hospitalization · median follow-up of 13.6 months
- Occurred in 39 patients
- 32.0%
New-onset AF · median follow-up of 13.6 months
- Developed in 17
- 13.9%
Original publication
Summarised from the published abstract; every number is checked against it