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Flow Reserve Does Not Predict Long-Term Outcomes After Transaortic Valve Implantation in Patients With Preserved Left
Marte Sævik1,2,3, Jan O Beitnes4, Lars Aaberge4
1The Intervention Centre, Rikshospitalet, Oslo University Hospital, Oslo, Norway.
Journal of Clinical Ultrasound : JCU
|April 28, 2025
Summary
Flow reserve in dobutamine stress echocardiography did not predict cardiovascular events one year after TAVI in patients with severe aortic stenosis. This measure offered no additional prognostic value for this patient group.
Area of Science:
- Cardiology
- Echocardiography
- Cardiovascular Events
Background:
- Severe aortic stenosis (AS) often requires transcatheter aortic valve implantation (TAVI).
- Predicting outcomes after TAVI in patients with preserved left ventricular ejection fraction (LVEF) is crucial.
- Flow reserve (FR) assessed during dobutamine stress echocardiography (DSE) is a potential prognostic marker.
Purpose of the Study:
- To evaluate if FR during DSE can predict major cardiovascular events (MACE) one year post-TAVI.
- To explore the association between FR and functional status (NYHA class, 6-min walk test) and quality of life (SF-36).
Main Methods:
- A cohort of 72 patients with severe AS and preserved LVEF underwent preoperative DSE.
- FR was defined as a ≥20% increase in stroke volume (SV) during DSE.
- Outcomes, including MACE, NYHA class, walking distance, and SF-36 scores, were assessed at 12-month follow-up.
Main Results:
- The average age was 80 years, with a mean peak aortic valve velocity of 4.7 m/s and LVEF of 65%.
- Twenty-five patients (36%) demonstrated FR.
- No significant differences in MACE, NYHA class, walking distance, or quality of life were observed between patients with and without FR at 1-year follow-up.
Conclusions:
- Flow reserve measured during low-dose dobutamine stress echocardiography does not predict long-term outcomes after TAVI in patients with severe AS and preserved LVEF.
- FR assessment provides no additional prognostic value for this specific patient population.
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