Background

Long term outcomes in diastolic dysfunction (DD) after transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS) remains controversial. The aim of this study is to determine changes in DD in severe AS patients before and 1-year after TAVR.

Methods

A retrospective study was conducted for patients who underwent TAVR at Beaumont Hospital (2015-2018). We collected patient demographics, comorbidities, echocardiographic data, and DD grades; we excluded patients with incomplete data. Baseline pre-procedure data were compared with 1-year follow-up. DD parameters of left ventricular ejections fraction (LVEF), E-wave, E/A ratio, E/e’ lateral and septal e’, left atrial volume index (LAVI), tricuspid regurgitation peak velocity (TR Pk Vel), and aortic mean gradient were obtained. Descriptive statistics, multivariate analysis, and independent T-tests were used.

Results

249 patients were included in the final analysis. At 1-year post-TAVR, there were significant increases in LVEF in Grades 2 and 3, LAVI in Grades 1 and 3, and TR peak velocity in all Grades. Grade 3 demonstrated the most significant improvement in diastolic parameters especially E/A ratio and E velocity. Moreover, there was a significant decrease in the incidence of Grade 2 and 3 with a resultant increase in normal and Grade 1.

Conclusion

There were significant improvements in the LVEF, LAVI, diastolic parameters, and diastolic function grading at 1-year. Most improvement was noted in advanced grades of DD.