Outcomes of Worsened Left Ventricular Ejection Fraction After Transcatheter Aortic Valve Replacement

Background: Left ventricular ejection fraction (LVEF) worsening after transcatheter aortic valve replacement (TAVR) was common in clinical practice. However, the effect of acute worsening LVEF is unclear. Methods: All consecutive patients who underwent TAVR between January 2016 and May 2022 were analyzed. Patients were divided into worsened LVEF and non-worsened LVEF according to whether or not they had an LVEF decline of >= 5% at discharge. Survival at follow-up was compared between two groups. Logistic regression analysis was used to determine independent predictors of worsening LVEF. Results: A total of 439 patients were included in the analysis, and 112 (25.5%) patients had worsened LVEF. Worsened LVEF was more common in patients with LVEF >= 50%. After multivariable logistic analysis, only baseline LVEF was associated with worsening LVEF [OR=1.06 (95% CI: 1.04-1.08), P < 0.001]. The decline in LVEF recovered to the baseline after one month. There were no significant differences in survival between patients with and without worsened LVEF (Log rank P = 0.48). Conclusion: Acute worsening of LVEF after TAVR was not uncommon but did not affect survival. It could recover to baseline levels after one month. Routine post-TAVR echocardiography should focus on other metrics rather than acute LVEF changes.