Table 1. Baseline Characteristics of Patients Undergoing TAVR With vs Without Early LVEF Improvement.
| Characteristic | No./total No. (%) | P value | |
|---|---|---|---|
| No LVEF improvement (n = 443) | LVEF improvement (n = 216) | ||
| Age, mean (SD), y | 82.1 (7.9) | 83.2 (7.4) | .09 |
| Sex | |||
| Male | 339/443 (76.5) | 129/216 (59.7) | <.001 |
| Female | 104/443 (23.5) | 87/216 (40.3) | |
| Race and ethnicitya | |||
| Asian | 2/443 (0.4) | 2/216 (0.9) | .90 |
| Black | 14/443 (3.2) | 9/216 (4.2) | |
| Hispanic | 8/443 (1.8) | 4/216 (1.8) | |
| White | 399/443 (90.1) | 192/216 (88.9) | |
| Other race | 20/443 (4.5) | 9/216 (4.2) | |
| BMI, mean (SD) | 27.4 (5.6) | 27.7 (6.6) | .59 |
| STS score, mean (SD) | 8.1 (4.4) | 8.9 (4.4) | .02 |
| NYHA class III/IV | 382/443 (86.2) | 197/216 (91.2) | .08 |
| Hypertension | 409/443 (92.3) | 189/216 (87.5) | .06 |
| Diabetes | 174/443 (39.3) | 71/216 (32.9) | .12 |
| Coronary artery disease | 367/443 (82.8) | 162/216 (75.0) | .02 |
| Prior MI | 154/443 (34.8) | 46/216 (21.3) | <.001 |
| Prior PCI | 163/442 (36.9) | 73/216 (33.8) | .49 |
| Prior CABG | 190/443 (42.9) | 61/216 (28.2) | <.001 |
| Prior BAV | 60/443 (13.5) | 28/216 (13.0) | .90 |
| Atrial fibrillation | 185/416 (44.5) | 57/175 (32.6) | .008 |
| Cerebrovascular disease | 37/443 (8.4) | 20/216 (9.3) | .77 |
| Peripheral artery disease | 137/443 (30.9) | 50/216 (23.1) | .04 |
| Chronic kidney diseaseb | 63/442 (14.3) | 21/216 (9.7) | .11 |
| COPD | 145/443 (32.7) | 73/216 (33.8) | .79 |
| Oxygen-dependent lung disease | 13/443 (2.9) | 10/216 (4.6) | .27 |
| Cancer | 146/443 (33.0) | 49/216 (22.7) | .007 |
| Katz Activities of Daily Living Index, mean (SD) | 5.5 (1.0) | 5.2 (1.3) | .002 |
| Hemoglobin, mean (SD), g/dL | 12.5 (6.5) | 11.9 (1.6) | .09 |
| Albumin <3.5 g/dL | 88/418 (21.1) | 46/184 (25.0) | .29 |
| Baseline echocardiographic data, mean (SD) | |||
| LVEF, % | 38.8 (8.4) | 35.6 (9.1) | <.001 |
| LV mass, g | 266.7 (81.8) | 260.5 (74.2) | .34 |
| LV mass index, g/m2 | 139.3 (39.5) | 140.9 (40.0) | .63 |
| LVEDD, cm | 5.2 (0.8) | 5.0 (0.7) | <.001 |
| LVESD, cm | 4.2 (0.9) | 4.0 (0.8) | .02 |
| AV peak velocity, cm/s | 406.1 (60.6) | 418.9 (71.6) | .03 |
| AV mean gradient, mm Hg | 39.8 (12.5) | 43.0 (15.1) | .006 |
| AV area, cm2 | 0.7 (0.2) | 0.6 (0.2) | .001 |
| LVOT Doppler stroke volume, mL | 62.0 (15.8) | 58.6 (17.5) | .02 |
| LVOT Doppler Stroke Volume Index, mL/m2 | 32.5 (8.1) | 31.5 (8.6) | .16 |
| ≥Moderate AR | 41/431 (9.5) | 23/210 (11.0) | .58 |
| ≥Moderate MR | 120/424 (28.3) | 54/209 (25.8) | .57 |
| Procedural characteristics | |||
| Valve size, mm | <.001 | ||
| 20 | 7/443 (1.6) | 1/216 (0.5) | |
| 23 | 81/443 (18.3) | 81/216 (37.5) | |
| 26 | 229/443 (51.7) | 97/216 (44.9) | |
| 29 | 126/443 (28.4) | 37/216 (17.1) | |
| Valve type | <.001 | ||
| SAPIEN | 84/443 (19.0) | 62/216 (28.7) | |
| SAPIEN XT | 205/443 (46.3) | 68/216 (31.5) | |
| SAPIEN 3 | 154/443 (34.8) | 86/216 (39.8) | |
| Predilation | 435/441 (98.6) | 214/216 (99.1) | .99 |
| Postdilation | 88/441 (20.0) | 54/213 (25.4) | .13 |
| Concomitant PCI | 3/343 (0.9) | 3/166 (1.8) | .40 |
| Need for second THV | 7/443 (1.6) | 1/216 (0.5) | .28 |
| Discharge medications | |||
| β-Blocker | 317/443 (71.6) | 156/216 (72.2) | .93 |
| ACE inhibitor/ARB | 234/443 (52.8) | 115/216 (53.2) | .93 |
| Procedural complications within 30 d | |||
| PPM | 36/443 (8.1) | 11/216 (5.1) | .20 |
| New atrial fibrillation | 21/443 (4.7) | 9/216 (4.2) | .84 |
| >Mild PVL | 39/434 (9.0) | 19/213 (8.9) | >.99 |
| 30-d Post-TAVR echocardiographic data | |||
| AV gradient, mean (SD), mm Hg | 9.6 (3.95) | 10.1 (3.40) | .10 |
| Severe prosthesis-patient mismatchc | 63/429 (14.7) | 22/208 (10.6) | .17 |
| ΔLVEF (30-d change from baseline), mean (SD), % | 1.1 (5.4) | 16.4 (5.7) | <.001 |
Abbreviations: ACE, angiotensin-converting enzyme; AR, aortic regurgitation; ARB, angiotensin II receptor blocker; AV, aortic valve; BAV, balloon aortic valvuloplasty; BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); CABG, coronary artery bypass grafting; COPD, chronic obstructive pulmonary disease; LV, left ventricular; LVEDD, left ventricular end-diastolic diameter; LVEF, left ventricular ejection fraction; LVESD, left ventricular end-systolic diameter; LVOT, left ventricular outflow tract; MI, myocardial infarction; MR, mitral regurgitation; NYHA, New York Heart Association; PCI, percutaneous coronary intervention; PPM, permanent pacemaker; PVL, paravalvular leak; STS, Society of Thoracic Surgeons; TAVR, transcatheter aortic valve replacement; THV, transcatheter heart valve.
SI conversion factors: To convert albumin to grams per liter, multiply by 10; creatinine to micromoles per liter, multiply by 88.4; hemoglobin to grams per liter, multiply by 10.
Race and ethnicity data were self-reported.
Serum creatinine >2 mg/dL.
Defined as indexed effective orifice area <0.65 cm2/m2.