PhD Scientific Days 2026

Poster Session 2.Q - Cardiovascular Medicine and Research

The association of myocardial work and cardiac damage stages with outcomes in transcatheter aortic valve replacement patients

Name of the presenter

Ladányi, Zsuzsanna

Institute/workplace of the presenter

Semmelweis University, Heart and Vascular Centre

Authors

Zsuzsanna Ladányi¹, Tímea Katalin Turschl¹, Eszter Pál¹, Veronika Párkányi¹, Tímea Bálint¹, Alexandra Fábián¹, Andrea Ferencz¹, Márton Tokodi¹, Andrea Nagy¹, Andrea Ágnes Molnár¹, Éva Straub¹, Csaba Fejér¹, Endre Zima¹, Levente Molnár¹, Attila Kovács¹, Mihály Ruppert¹, Béla Merkely¹, Bálint Károly Lakatos¹
1: Semmelweis University, Heart and Vascular Centre

Text of the abstract

Aortic stenosis (AS) is accompanied by chronically elevated LV afterload, which can lead to severe backward damage, which can be classified into distinct stages. Also, assessing left ventricular (LV) systolic function in AS patients remains difficult, because the elevated afterload heavily influences conventional echocardiographic parameters. Myocardial work (MW) analysis is a cutting-edge method combining myocardial strain with instantaneous LV pressure resulting in a more load-independent evaluation of LV contractility.
The aim of this study was to investigate the prognostic value of cardiac damage staging and MW parameters in the complex population undergoing transcatheter aortic valve replacement (TAVR).
319 patients scheduled for TAVR were prospectively enrolled (79 ± 6 years; 40% female). Comprehensive echocardiographic exams were performed one day prior to the intervention. Cardiac damage staging was based on the echocardiographic data according tot he Généreux classification. Global constructive work (GCW) was derived using dedicated software. The primary outcomes were all-cause mortality and heart failure hospitalization, the composite endpoint consisting of these was reached by 97 patients over a median follow-up of 29 months.
Preoperative GCW was 2033±767 mmHg%. Both cardiac damage staging (HR 1.195 [95% CI 1.009-1.415]; p=0.039) and GCW (HR 0.970 [95% CI 0.944-0.996]; per 100-unit change p=0.023) were significant predictors of the composite endpoint. Patients were classified into two categories based on cardiac damage stage: Low Stage (Stages 0–2) and High Stage (Stages 3–4). Similarly, they were divided into Low GCW (< median GCW, 1979 mmHg%) and High GCW (≥ median GCW) groups. This resulted in four subgroups: Low Stage–Low GCW, Low Stage–High GCW, High Stage–Low GCW and High Stage–High GCW. Using Kaplan-Meier survival curves a significant difference was observed among all groups (log-rank p=0.027), with a particularly notable difference between the Low Stage–High GCW and High Stage–High GCW groups (log-rank p=0.006).
In our TAVR cohort cardiac damage stages and preoperative GCW values were predictors of the composite endpoint combining all-cause mortality and heart failure hospitalization. Moreover, there was a particularly significant difference between the outcomes of the Low Stage–High GCW and High Stage–High GCW subgroups.