Valvular & structural heart disease
Multiorgan Dysfunction and its Association With Congestion and Outcome in Aortic Stenosis Treated With Transcatheter Aortic Valve Implantation (TAVI)
Authors' conclusion
Biomarker abnormalities are highly prevalent in severe AS, influenced by congestion, and associated with impaired prognosis post-TAVI. Multiorgan dysfunction faces a particularly dismal outcome.
Study context
- Population
- Patients with severe aortic stenosis undergoing TAVI
- Participants
- 880 patients
- Outcome
- Time to first heart failure hospitalization or death
- Follow-up
- 2.4 ± 1.0 years
Main finding
As reported in the abstract
Reached the primary endpoint
27%
Heart failure hospitalization
29
Deaths
194
Both
13
Further findings
| Outcome | Adjusted HR (95% CI) | |
|---|---|---|
| Event hazard per affected extra-cardiac domain71% increase in event hazard | 1.71 (1.39–2.11) | |
| 0.512Adjusted hazard ratio (log scale) |
Fluid overload (≥1.0 L) and biomarker abnormalities
- Fluid overload (FO)
- 41%
- Biomarker abnormalities of at least one domain
- 89%
Fluid levels and biomarkers
- Ascending fluid levels independently associated with distorted biomarkers across domains of myocyte stress, hepatic dysfunction, renal dysfunction, inflammation, and anemia
Biomarkers and outcomes
- Biomarkers across all domains individually and independently associated with outcomes
Combination of distorted biomarkers and FO
- For each domain, the combination of distorted biomarkers and FO had the highest event risk
Original publication
Multiorgan Dysfunction and its Association With Congestion and Outcome in Aortic Stenosis Treated With TAVI. JACC Adv. Published 9 January 2025. doi:10.
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