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February 24, 20260 citationsOpen Access

Myocardial Work Indices Predict Survival Post TAVI in Aortic Stenosis Patients

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MBMichał Jakub BłaszkiewiczTWTomasz G. WitkowskiWBWojciech Bombała

Key Result

Pre-TAVI GWI <1497 mmHg, GCW <1975 mmHg, and GWE <85% independently predicted higher all-cause mortality in aortic stenosis patients with 29% mortality observed.

Key Points

  • The study aims to assess the predictive value of myocardial work indices for mortality in aortic stenosis patients undergoing TAVI.
  • Evaluated 116 consecutive patients qualified for TAVI from March 2021 to November 2022.
  • Assessed pre-procedural left ventricle myocardial work indices including GWI, GCW, GWW, and GWE.
  • Analyzed long-term survival using univariate and multivariate Cox proportional hazard models.
  • Median survival time post-TAVI was 1404 days, with a maximum of 1721 days.
  • All-cause mortality during follow-up was 29%.
  • Multivariate analysis identified EF, GLS, GWI, GWE, and GCW as independent mortality predictors.
  • Optimal cut-off values for GCW, GWI, and GWE were found to be 1975 mmHg, 1497 mmHg, and 85%, respectively.

Structured PICO

Do pre-procedural Left Ventricle Myocardial Work (LVMW) indices predict long-term survival in patients with aortic stenosis undergoing TAVI?

P
Population
116 consecutive patients with aortic stenosis who were qualified for Transcatheter Aortic Valve Implantation (TAVI)
I
Intervention
Pre-procedural assessment of Left Ventricle Myocardial Work (LVMW) indices (Global Work Index [GWI], Global Constructive Work [GCW], Global Wasted Work [GWW], and Global Work Efficiency [GWE])
O
Outcome
All-cause mortality (long-term survival)hard clinical

Pre-procedural myocardial work indices, specifically GCW, GWI, and GWE, are independent predictors of long-term all-cause mortality and can effectively stratify risk in patients undergoing TAVI.

Abstract

Background: Left Ventricle Myocardial Work (LVMW) has shown utility in assessing patients with aortic stenosis (AS) in recent studies. In the present study, we evaluated the predictive value and optimal cut-off values of LVMW parameters measured prior to TAVI that may be associated with increased mortality in AS patients. Methods: A total of 116 consecutive patients who were qualified for TAVI between March 2021 and November 2022 were evaluated. Pre-procedural LVMW indices (GWI, GCW, GWW, and GWE) were assessed and long-term survival was analysed. Survival and influencing factors were evaluated using univariate and multivariate Cox proportional hazard models, with significant factors subsequently included in cut-off analysis. Results: The median survival time following the TAVI procedure was 1404 (1143–1549) days, with a maximum observation period of 1721 days. All-cause mortality during the follow-up period reached 29%. Multivariate analysis revealed that EF, GLS, GWI, GWE and GCW before TAVI were independent predictors of all-cause mortality. We identified 1975 mmHg, 1497 mmHg and 85% as optimal cut-off values for GCW, GWI and GWE, which allow for significant stratification of patients according to risk. Conclusions: In this analysis, baseline-assessed parameters such as GLS, GWI, GWE, and GCW emerged as independent predictors of all-cause mortality. The proposed cut-off values clearly separated patient groups with different survival outcomes.

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Cite This Study

Błaszkiewicz et al. (2026) studied this question. Pre-TAVI GWI <1497 mmHg, GCW <1975 mmHg, and GWE <85% independently predicted higher all-cause mortality in aortic stenosis patients with 29% mortality observed.

synapsesocial.com/papers/699d3fb3de8e28729cf6464bhttps://doi.org/10.3390/jcm15041645
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