Right Ventricular Function and a Novel Biomarker After TAVI: Clinical Implications of IGFBP-7

Aortic stenosis (AS) is the most common valvular heart disease in elderly patients, and transcatheter aortic valve implantation (TAVI) has become the preferred treatment option in this population. Right ventricular dysfunction (RVD) is a marker of advanced disease and poor prognosis; however, its clinical impact and reversibility after TAVI remain unclear. Insulinlike growth factor binding protein-7 (IGFBP-7), a biomarker associated with endothelial function and myocardial stress, has been linked to heart failure and adverse cardiovascular outcomes. This prospective study aimed to evaluate changes in right ventricular function after TAVI and to investigate the relationship between IGFBP-7 levels and clinical, echocardiographic, and laboratory parameters during follow up. Our findings may provide insight into right ventricular recovery after TAVI and the potential prognostic role of IGFBP-7 in this setting.

Demographic data (age, gender, height, weight), basic echocardiographic parameters and routine blood laboratory tests of patients who applied to our clinic and underwent TAVI due to severe AS were recorded before TAVI and at 48 h and 6 months after the procedure. A prospective study was designed.

The study included 116 individuals, 76 (65.5%) of whom were patients and 40 (34.5%) were controls. Both groups had similar age and gender characteristics. It was shown that there was improvement in the parameters indicating right ventricular function (PAP, RVSM and TAPSE) measured in the preoperative period at the postoperative 48th hour and at the postoperative sixth month follow-up after TAVI. IGFBP-7 level was higher in the preoperative patient group compared to the postoperative sixth month follow-up. It was found that IGFBP-7 levels showed positive correlations with proBNP, CRP, left atrial volume index (LAVI) and negative correlations with EF Simpson and EGFR at the postoperative sixth month follow-up.

Our study shows that TAVI not only relieves anatomic obstruction but also may contribute to improving right ventricular functions, valve insufficiency degrees, and systemic biomarker levels. IGFBP-7 was found to be significantly associated with both cardiac (proBNP, EF, LAVI) and renal (eGFR) functions, suggesting that this marker may be a biomarker reflecting multisystem organ effects. Further studies with larger patient groups and long term follow up will contribute to the validation of these findings and their integration into clinical practice.