Outcome of patients with heart failure after transcatheter aortic valve implantation

Autoři: Ulrich Fischer-Rasokat aff001;  Matthias Renker aff001;  Christoph Liebetrau aff001;  Maren Weferling aff001;  Andreas Rolf aff001;  Mirko Doss aff003;  Helge Möllmann aff005;  Thomas Walther aff003;  Christian W. Hamm aff001;  Won-Keun Kim aff001
Působiště autorů: Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany aff001;  Department of Cardiology and Angiology, Medical Clinic I, University Hospital of Giessen, Giessen, Germany aff002;  Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany aff003;  German Centre for Cardiovascular Research (DZHK), Partner Site RheinMain, Bad Nauheim, Germany aff004;  Department of Cardiology, Medical Clinic I, St. Johannes Hospital, Dortmund, Germany aff005;  Department of Cardiac, Thoracic and Thoracic Vascular Surgery, University Hospital of the Goethe University, Frankfurt/Main, Germany aff006
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225473



Patients with aortic stenosis (AS) may have concomitant heart failure (HF) that determines prognosis despite successful transcatheter aortic valve implantation (TAVI). We compared outcomes of TAVI patients with low stroke volume index (SVI) ≤35 ml/m2 body surface area in different HF classes.

Methods and results

Patients treated by transfemoral TAVI at our center (n = 1822) were classified as 1) ‘HF with preserved ejection fraction (EF)’ (HFpEF, EF ≥50%), 2) ‘HF with mid-range EF’ (HFmrEF, EF 40–49%), or 3) ‘HF with reduced EF’ (HFrEF, EF <40%). Patients with SVI >35 ml/m2 served as controls. The prevalence of cardiovascular disease and symptoms increased stepwise from controls (n = 968) to patients with HFpEF (n = 591), HFmrEF (n = 97), and HFrEF (n = 166). Mortality tended to be highest in HFrEF patients 30 days post-procedure, and it became significant after one year: 10.2% (controls), 13.5% (HFpEF), 13.4% (HFmrEF), and 23.5% (HFrEF). However, symptomatic improvement in survivors of all groups was achieved in the majority of patients without differences among groups.


Patients with AS and HF benefit from TAVI with respect to symptom alleviation. TAVI in patients with HFpEF and HFmrEF led to an identical, favorable post-procedural prognosis that was significantly better than that of patients with HFrEF, which remains a high-risk population.

Klíčová slova:

Aortic valve – Blood pressure – Body Mass Index – Death rates – Ejection fraction – Heart failure – Chronic obstructive pulmonary disease – Prognosis


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2019 Číslo 11