Gait and fate: Baseline gait speed and mortality after transcatheter aortic valve implantation
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Updated: Dec 27, 2025
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Hisato Takagi1, Michitaka Kato2, Yosuke Hari1
1Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan; Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Insights
Slow baseline gait speed predicts higher mortality after transcatheter aortic valve implantation (TAVI). Patients unable to walk also face increased mortality risk post-TAVI, highlighting gait speed as a key prognostic indicator.
Area of Science:
- Cardiology
- Geriatrics
- Clinical Medicine
Background:
- Transcatheter aortic valve implantation (TAVI) is a crucial procedure for aortic stenosis.
- Assessing preprocedural patient risk is vital for optimizing TAVI outcomes.
- Gait speed is a recognized functional measure with prognostic implications.
Purpose of the Study:
- To determine if baseline gait speed predicts mortality following TAVI.
- To synthesize evidence from existing studies on gait speed and TAVI outcomes.
- To establish gait speed as a predictive biomarker for post-TAVI mortality.
Main Methods:
- A comprehensive meta-analysis of studies published through May 2019 was conducted.
- PubMed and Web of Science databases were searched for relevant research.
- Hazard ratios (HRs) and odds ratios (ORs) for mortality associated with gait speed were pooled using a random-effects model.
Main Results:
- Twelve studies were included in the meta-analysis.
- Slow gait speed was significantly associated with increased mortality (HR/OR, 2.38; p < 0.00001).
- Patients unable to walk also showed increased mortality (HR/OR, 1.75; p = 0.01).
Conclusions:
- Baseline gait speed is a significant predictor of mortality after TAVI.
- Slower gait speed, including the inability to walk, indicates a higher risk of death post-procedure.
- Gait speed assessment can aid in risk stratification for TAVI patients.
Background:
To determine whether baseline gait speed predicts mortality after transcatheter aortic valve implantation (TAVI), a meta-analysis of currently available studies was performed.
Methods:
To identify all studies researching the impact of preprocedural gait speed on mortality after TAVI, PubMed and Web of Science were searched through May 2019. Adjusted (if unavailable, unadjusted) hazard/odds ratios (ORs/HRs) with their confidence interval of mortality for slow (if available, the slowest) versus fast (if available, the fastest) gait speed (with cut-off values defined in each study) and those for unable to walk versus walker (if available, with the fastest gait speed) were extracted from each study, and then separately pooled by means of inverse variance-weighted averages of logarithmic ORs/HRs in the random-effects model.
Results:
Twelve eligible studies (7 and 5 based on the distance-limited and time-limited walk test, respectively) were identified and integrated in the present meta-analysis. The pooled analysis of all ORs/HRs demonstrated that slow walkers (primary meta-analysis; OR/HR, 2.38; p < 0.00001) and unable to walk (OR/HR, 1.75; p = 0.01) were significantly associated with increased mortality. The subgroup analysis for the primary meta-analysis indicated no significant subgroup difference between studies utilizing the 4-m/5-m/15-foot walk test and those applying the 6-min walk test (p = 0.45). Combining studies with 1-year follow-up did not alter the primary result (p < 0.0001). Pooling studies with adjusted ORs/HRs did not change the principal result (p = 0.0002). No funnel plot asymmetry for the primary meta-analysis was identified.
Conclusions:
Slow baseline gait speed (and unable to walk) is associated with increased mortality after TAVI.
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