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Aortic regurgitation after TAVR increased mortality in some patients
Among patients with moderate or severe aortic regurgitation after transcatheter aortic valve replacement, 2-year mortality was increased among those with low N-terminal pro-brain natriuretic peptide values, according to recent findings.
Researchers of the study investigated whether aortic regurgitation is associated with increased mortality in the TAVR setting by examining baseline N-terminal pro-brain natriuretic peptide (NT-proBNP) in a cohort of 236 patients from a single center. All patients received transfemoral implantation of the Sapien or Sapien XT transcatheter valves (Edwards Lifesciences). Researchers used transthoracic echocardiography to evaluate aortic regurgitation and measured NT-proBNP 24 hours before the procedure. Patients were stratified by median NT-proBNP value.
Median patient age was 85 years, and 58.1% were women.
Patients with high NT-proBNP values had 52% (35-65) lower left ventricular ejection fraction compared with 63% (55-70) for the low NT-proBNP group (P<.001). High NT-proBNP also was associated with larger telediastolic diameters (56 mm vs. 52 mm; P=.01) and more severe aortic stenosis (0.62 ± 0.15 cm2 vs. 0.70 ± 0.2 cm2; P<.001).
In addition, the researchers reported pre-procedural moderate or severe aortic regurgitation was 42% in the high peptide group compared with 26% in the low group (P=.013). Mitral regurgitation was also more frequent in the high NT-proBNP group (56% vs. 36%; P=.004).
Moderate or severe aortic regurgitation occurred in 26% of the cohort after TAVR. Among these patients, 2-year mortality was increased in the low NT-proBNP group. There was no increase in mortality among patients with high NT-proBNP and moderate or severe aortic regurgitation.
“Our results, if confirmed in larger populations, could have important clinical implications for patient selection for [TAVR] and treatment of post-procedural [aortic regurgitation],” the researchers concluded.
Disclosure: The researchers report financial disclosures with Edwards Lifesciences.