Abstract 197: Predictors of Early Left Ventricular Ejection Fraction Recovery in Patients Following Transcatheter Aortic Valve Replacement

Background: Transcatheter aortic valve replacement (TAVR) is recommended by guidelines in severe aortic stenosis (AS) in patients with high or intermediate surgical risk. However, AS and reduced left ventricular ejection fraction (LVEF) is associated with worse clinical outcomes. Many of these patients will have LVEF recovery after TAVR. The purpose of this study was to evaluate the predictors of early LVEF recovery. Methods: All patients with a baseline LVEF < 50% who underwent TAVR and had an echocardiogram within one-month post-TAVR (n=39) at a single center were included to determine the factors that predict an improvement in early LVEF. A 10% increase in LVEF within one month was used as a definition of early improvement in LVEF. Chi-square and T-test were used to examine differences in baseline characteristics between subjects with and without improvement in early LVEF. Results: The patient cohort was 77 ± 9 years, 76.9% male, STS 6.2 ± 3.7. Among the 56% who had an improvement in early LVEF, they were more likely to have a lower left ventricular end diastolic diameter (LVEDD) (5.0±0.8 cm vs. 5.7±0.6 cm; p-value = 0.01) and left ventricular end systole diameter (LVESD) (3.7±0.8 cm vs. 4.5±1.1 cm; p-value = 0.02). These patients were more likely to have a higher interventricular septum diastolic thickness (IVSd) (1.2±0.2 cm vs. 1.0±0.2 cm; p-value = 0.01) and less likely to have a pre-existing peripheral vascular disease (PVD; 13% vs. 50%; p-value=0.01). Conclusion: Our study suggests that LVEDD, LVESD, IVSd, and PVD may be used to predict early improvement in LVEF. These factors need to be further prospectively validated to determine patients who are more likely to benefit from TAVR.