Title : Baseline TAPSE and Early Mortality After TAVI: A Small Real-World Cohort Study
Abstract:
Background: Right ventricular dysfunction is increasingly recognized as an important determinant of outcome after transcatheter aortic valve implantation (TAVI). Tricuspid annular plane systolic excursion (TAPSE) is a simple and widely available echocardiographic parameter of right ventricular systolic function. We evaluated whether baseline TAPSE was associated with early mortality after TAVI in a small real-world cohort.
Methods: We retrospectively analyzed 21 consecutive patients with severe aortic stenosis who underwent TAVI at our center between 2022 and 2024. Pre-procedural TAPSE was measured by M-mode echocardiography from the apical four-chamber view. Patients were stratified into reduced TAPSE (<17 mm, n=7) and preserved TAPSE (≥17 mm, n=14) groups. The primary outcome was 30-day all-cause mortality.
Results: Three patients (14.3%) died within 30 days after TAVI. Patients with TAPSE <17 mm had a higher observed 30-day mortality than those with TAPSE ≥17 mm (28.6% vs 7.1%). The low-TAPSE group also had significantly higher pulmonary artery systolic pressure (45±12 vs 32 ±10 mmHg, p=0.03), suggesting increased right ventricular afterload. In exploratory analysis, non-survivors had a lower TAPSE/PASP ratio than survivors, indicating a trend toward impaired right ventricle-pulmonary artery coupling.
Conclusions: In this small single-center cohort, reduced baseline TAPSE was associated with worse early outcome after TAVI and may serve as a practical tool for pre-procedural risk stratification. These findings should be interpreted cautiously because of the limited sample size and event count, and they should be considered hypothesis-generating rather than definitive.
