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April 7, 2026Journal of Cardiothoracic Surgery0 citationsOpen Access

Early reversal of cardiac remodeling in patients with new-onset persistent left bundle branch block after transcatheter aortic valve replacement

SWShuzhen WangKTKunyue TanXGXiaoqiang Gao

Key Result

New-onset persistent left bundle branch block after TAVR impaired early cardiac reverse remodeling at 6 months, including increased left ventricular mass index and reduced ejection fraction.

Key Points

  • This study aims to evaluate how new-onset persistent left bundle branch block affects cardiac remodeling after transcatheter aortic valve replacement.
  • Retrospective analysis of 101 patients undergoing TAVR for severe aortic stenosis.
  • Echocardiographic measurements were taken preoperatively, and at 1 and 6 months post-TAVR.
  • Clinical outcomes were monitored during the follow-up period.
  • 27.7% of patients developed new-onset persistent left bundle branch block after TAVR.
  • At 6 months, the new-LBBB group showed increased left ventricular diameter and mass index and decreased left ventricular ejection fraction.
  • Mitral regurgitation improved in the no-LBBB group at 1 month but worsened in the new-LBBB group by 6 months.
  • No significant difference in rehospitalization rates was observed between groups within 6 months postoperatively.

Study Design

Type

Cohort (n=101)

Multicenter

No

Structured PICO

Does new-onset persistent LBBB after TAVR affect early cardiac reverse remodeling and short-term rehospitalization in patients with severe aortic stenosis?

P
Population
101 patients older than 61 years with severe aortic stenosis who underwent successful transfemoral transcatheter aortic valve replacement (TAVR) with self-expanding valves. Excluded: history of LBBB or pacemaker, high degree perioperative atrioventricular block, or LBBB reversal within 1 month.
I
Intervention
Development of new-onset persistent left bundle branch block (LBBB) following TAVR
C
Comparator
No development of new-onset persistent LBBB following TAVR
O
Outcome
Early cardiac reverse remodeling (echocardiographic variables including left ventricular diameter, left ventricular mass index, and left ventricular ejection fraction) and rehospitalization rates at 6 months postoperativelysurrogate

New-onset persistent LBBB after TAVR is associated with adverse early cardiac structural and functional remodeling at 6 months, despite having no significant impact on short-term rehospitalization rates.

Main Result

p-value: p=<0.05

Limitations

  • Single-center surgical experience, which may introduce selection bias
  • The technology of the center is in the stage of accumulating experience, so physician skill may impact the incidence of new LBBB
  • Short-term follow-up, meaning the results cannot reflect long-term outcomes
  • Technology and physician skill at the center are in the stage of accumulating experience, which may impact the incidence of new LBBB
  • Short-term follow-up cannot reflect long-term outcomes

Abstract

Abstract Objective New-onset persistent left bundle branch block (LBBB) following transcatheter aortic valve replacement (TAVR) is an independent predictor of long-term cardiovascular mortality in patients. The aim of this study is to evaluate the impact of new-onset LBBB on early cardiac reverse remodeling and clinical outcomes after TAVR. Methods A retrospective analysis was performed on 101 patients who underwent successful TAVR for severe aortic stenosis between March 2021 and October 2024 at our institution. Echocardiographic variables indicative of cardiac remodeling were analysed preoperatively and at one and six months after TAVR. Furthermore, the clinical outcomes of the patients were monitored during the follow-up period. Result Of the 101 patients who underwent TAVR, 28 (27.7%) had new-onset LBBB. Transcatheter heart valve(THV) implantation depth was an influential factor for new LBBB, which was more prevalent in patients with thinner interventricular septal thickness preoperatively. At the six-month follow-up, the new-LBBB group showed an increase in left ventricular diameter and left ventricular mass index and a reduction in left ventricular ejection fraction compared with the preoperative period. Mitral regurgitation in the no-LBBB group was significantly reduced at 1 month postoperatively. In contrast, mitral regurgitation in new-LBBB group was reduced at one month postoperatively, but worsened at six months.There was no significant difference in rehospitalization rates within 6 months postoperatively between patients with or without LBBB. Conclusions New-onset persistent LBBB after TAVR did not affect short-term rehospitalization, but may adversely affect early postoperative reversal of cardiac remodeling.

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Cite This Study

Wang et al. (2026) conducted a cohort in Severe aortic stenosis (n=101). New-onset persistent left bundle branch block (LBBB) vs. No new-onset LBBB was evaluated on Early cardiac reverse remodeling (changes in left ventricular diameter, LVMI, and LVEF) at 6 months (p=<0.05). New-onset persistent left bundle branch block after TAVR impaired early cardiac reverse remodeling at 6 months, including increased left ventricular mass index and reduced ejection fraction.

synapsesocial.com/papers/69d49fc5b33cc4c35a2283e3https://doi.org/10.1186/s13019-026-03961-w
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