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Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Heart Failure Drugs: β-Blockers01:22

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β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Updated: Jul 4, 2025

Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
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Transcatheter aortic valve replacement in heart failure.

Puja B Parikh1, Michael Mack2, Gregg W Stone3

  • 1Department of Medicine, Stony Brook Renaissance School of Medicine, Stony Brook, NY, USA.

European Journal of Heart Failure
|February 1, 2024
PubMed
Summary

Transcatheter aortic valve replacement (TAVR) improves outcomes for patients with severe aortic stenosis and heart failure. This review details TAVR

Keywords:
Aortic stenosisEjection fractionHeart failureTranscatheter aortic valve interventionTranscatheter aortic valve replacement

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Heart Failure Management

Background:

  • Severe aortic stenosis (AS) can lead to heart failure (HF), historically associated with poor prognosis.
  • Transcatheter aortic valve replacement (TAVR) is now a primary treatment for AS patients with HF.
  • TAVR provides immediate hemodynamic benefits, improving cardiac structure, survival, and quality of life in HF patients.

Purpose of the Study:

  • To review the impact of TAVR on outcomes in patients with heart failure.
  • To focus on specific HF populations: left ventricular systolic dysfunction, acute HF, and right ventricular systolic dysfunction.
  • To identify knowledge gaps and future research directions regarding TAVR in AS with HF.

Main Methods:

  • Literature review of studies evaluating TAVR in patients with aortic stenosis and heart failure.
  • Analysis of hemodynamic changes, left ventricular remodeling, and survival data post-TAVR.
  • Synthesis of evidence on TAVR outcomes across different HF phenotypes.

Main Results:

  • TAVR demonstrates significant hemodynamic benefits and improvements in left ventricular structure.
  • Patients with AS and HF undergoing TAVR show enhanced mortality and quality of life.
  • Outcomes in specific HF subgroups (LV systolic dysfunction, acute HF, RV systolic dysfunction) require further investigation.

Conclusions:

  • TAVR is an effective treatment for severe AS patients with heart failure, improving hemodynamics and long-term outcomes.
  • Further research is needed to clarify prognostic factors and optimal TAVR timing, especially in less severe AS and specific HF presentations.
  • TAVR represents a paradigm shift in managing AS complicated by heart failure.