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Updated: Aug 12, 2026
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Prognostic Impact of Gait Speed Changes During Hospitalization in Patients Undergoing Transcatheter Aortic Valve
Shinya Tajima1, Kentaro Hori1, Daichi Kobayashi1
1Department of Rehabilitation, Sakakibara Heart Institute Tokyo Japan.
Background:
Pre- and post-hospitalization gait speed are known prognostic indicators in patients undergoing transcatheter aortic valve implantation (TAVI); however, the impact of changes in gait speed during hospitalization on prognosis remains unclear. This study investigated the effect of in-hospital gait speed changes on survival outcomes.
Methods And Results:
We retrospectively analyzed 1,082 patients (mean age 85 years) who underwent TAVI between 2013 and 2022. Gait speed was assessed at admission (pre-TAVI) and at discharge. Patients were classified into 4 groups based on baseline gait speed (normal/slow) and in-hospitalization change (non-decreased/decreased): Normal/Non-DG (n=420); Normal/DG (n=197); Slow/Non-DG (n=385); and Slow/DG (n=80). The primary outcome was post-discharge all-cause mortality. During a mean follow up of 3.1 years, 255 (24%) patients died. In a multivariable Cox model, compared with the Normal/Non-DG group, mortality risk was higher in the Normal/DG group (hazard ratio [HR] 1.905; 95% confidence interval [CI] 1.230-2.951; P=0.004) and the Slow/DG group (HR 2.102; 95% CI 1.186-3.728; P=0.011), whereas the Slow/Non-DG group showed no significant difference (HR 1.373; 95% CI 0.927-2.034; P=0.114).
Conclusions:
A decline in gait speed during hospitalization was associated with a higher risk of post-discharge all-cause mortality. This association remained after multivariable adjustment, even among patients with normal gait speed at admission. These findings suggest that in-hospital gait speed change may serve as a clinically meaningful prognostic marker in patients undergoing TAVI.
