Department of Medicine, Stony Brook Renaissance School of Medicine, Stony Brook, NY, USA.
Department of Cardiac Surgery, Baylor Scott & White Health, Plano, TX, USA.
Eur J Heart Fail. 2024 Feb;26(2):460-470. doi: 10.1002/ejhf.3151. Epub 2024 Jan 31.
Patients with severe aortic stenosis (AS) may develop heart failure (HF), the presence of which has traditionally been deemed as a final stage in AS progression with poor outcomes. The use of transcatheter aortic valve replacement (TAVR) has become the preferred therapy for most patients with AS and concomitant HF. With its instant afterload reduction, TAVR offers patients with HF significant haemodynamic benefits, with corresponding changes in left ventricular structure and improved mortality and quality of life. The prognostic covariates and optimal timing of TAVR in patients with less than severe AS remain unclear. The purpose of this review is to describe the association between TAVR and outcomes in patients with HF, particularly in the setting of left ventricular systolic dysfunction, acute HF, and right ventricular systolic dysfunction, and to highlight areas for future research.
患有严重主动脉瓣狭窄（AS）的患者可能会出现心力衰竭（HF），传统上认为 HF 的出现是 AS 进展的终末期，预后较差。经导管主动脉瓣置换术（TAVR）已成为大多数 AS 合并 HF 患者的首选治疗方法。TAVR 可立即降低后负荷，为 HF 患者带来显著的血液动力学益处，左心室结构相应改变，死亡率和生活质量提高。在 AS 程度较轻的患者中，TAVR 的预后协变量和最佳时机仍不清楚。本文旨在描述 TAVR 与 HF 患者结局之间的关联，特别是在左心室收缩功能障碍、急性 HF 和右心室收缩功能障碍的情况下，并强调未来研究的领域。
