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Impact of Triglycerides and Remnant Particles on Hemodynamic Valve Deterioration After Transcatheter Aortic Valve

Revathy Sampath-Kumar1, Erika Padilla1, Michael Wilkinson1

  • 1University of California-San Diego, Division of Cardiovascular Medicine, La Jolla, California, USA.

JACC. Advances
|October 22, 2025
PubMed

Insights

Elevated triglycerides and remnant cholesterol are linked to increased hemodynamic valve deterioration (HVD) after transcatheter aortic valve replacement (TAVR). Managing these cardiometabolic factors may improve TAVR valve longevity.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Clinical Research

Background:

  • Hemodynamic valve deterioration (HVD) is a concern after transcatheter aortic valve replacement (TAVR).
  • The influence of cardiometabolic factors, including atherogenic lipids, on HVD post-TAVR remains understudied.

Purpose of the Study:

  • To investigate the association between cardiometabolic factors and HVD in patients who have undergone TAVR.
  • To identify specific lipid profiles or metabolic markers that correlate with adverse valve outcomes.

Main Methods:

  • Retrospective analysis of 555 patients undergoing TAVR from May 2013 to December 2022.
  • Echocardiographic follow-up was used to assess moderate or severe HVD, with all-cause death as a competing risk.
  • Statistical analysis included hazard ratios and cumulative incidence to evaluate associations with cardiometabolic factors.

Main Results:

  • Elevated triglycerides (>100 mg/dL) were significantly associated with a higher cumulative incidence of HVD (HR: 3.81).
  • Increased remnant cholesterol levels also correlated with a higher incidence of HVD (HR: 1.03).
  • Elevated triglycerides were linked to a faster annualized rate of change in peak aortic jet velocity, indicating accelerated valve dysfunction.

Conclusions:

  • Elevated triglycerides and remnant cholesterol are independent risk factors for HVD following TAVR.
  • These findings suggest that optimizing cardiometabolic risk factors, particularly lipid management, could be a viable strategy to enhance the longevity of TAVR prostheses.
  • Further research is warranted to confirm these associations and explore therapeutic interventions.
Abstract

Keywords:
bioprosthetic valve failurecardiometabolic healthtranscatheter aortic valve replacement

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