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Language: enSubject: Heart Failure

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    Article
    Predictive Factors of Cardiac Function Recovery and Mortality in Patients With Reduced Ejection Fraction Undergoing Transcatheter Aortic Valve Implantation
    (Mdpi, 2025) Guney, Murat Can; Suygun, Hakan; Polat, Melike; Ayhan, Huseyin; Keles, Telat; Ertop, Zeynep Seyma Turinay; Bozkurt, Engin
    Background and Objectives: Patients with reduced left ventricular ejection fraction (LVEF) are reported to have unfavorable outcomes following transcatheter aortic valve implantation (TAVI). This study aims to evaluate outcomes and identify predictive factors for LVEF recovery following TAVI in patients with reduced LVEF. Materials and Methods: This retrospective study analyzed 114 patients with symptomatic severe aortic stenosis (AS) with LVEF < 40% who underwent TAVI between 2011 and 2023 at two centers. Echocardiographic parameters, including LVEF, ventricular dimensions, and relative wall thickness (RWT), were assessed at baseline and during follow-up. The outcomes and predictors of substantial LVEF improvement and mortality were analyzed using univariate and multivariate logistic regression methods. Results: Anemia (OR = 4.345, 95% CI: 1.208-15.626, p = 0.024), RWT (OR = 1.224, 95% CI: 1.064-1.407, p = 0.005), and early post-procedural changes in left ventricular end-systolic dimension (LVESD) (OR = 1.297, 95% CI: 1.037-1.622, p = 0.023) and left ventricular end-diastolic dimension (LVEDD) (OR = 1.346, 95% CI: 1.034-1.753, p = 0.027) at one-month follow-up were identified as significant factors associated with LVEF recovery at one year. Regarding factors related to mortality, higher baseline AVMG levels were associated with a lower probability of death after one year (OR = 0.926, 95% CI: 0.875-0.979, p = 0.007). Conversely, a more limited increase in LVEF from baseline to the final follow-up was linked to poor prognosis and higher mortality at one year (95% CI: 1.045-1.594, p = 0.018). Conclusions: This study demonstrated that TAVI in patients with AS and reduced LVEF can be performed with high procedural success, low mortality, and significant improvement in cardiac function during follow-up. Additionally, anemia, baseline RWT, and early post-procedural changes in LVESD and LVEDD were identified as factors associated with LVEF recovery. Baseline AVMG and changes in LVEF at the final follow-up were found to be significant predictors of total mortality.
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    Article
    Recovery of Myocardial Functions After Kidney Transplantation in Patients With Heart Failure Due To Uremic Cardiomyopathy
    (Kare Publ, 2025) Ozates, Yelda Saltan; Odabasi, Ahmet Yener; Yildiz, Ufuk; Albayrak, Duygu Genc; Inan, Duygu; Bas, Serap; Tekkesin, Ahmet Ilker
    Objective: Although left ventricular hypertrophy frequently accompanies end-stage renal disease, heart failure (HF) with reduced ejection fraction (EF) is also observed in a subset of patients. In those patients kidney transplantation (KT) is generally avoided due to an increased risk of mortality in addition to the risks associated with HF. This prospective study was designed to follow patients with HF who were being prepared for KT. Methods: Twenty-five patients with HF due to uremic cardiomyopathy (UC) who had suitable donors (Group 1), 22 patients with HF who could not undergo KT due to a lack of kidney donors (Group 3), and 25 KT candidates with normal ventricular function (Group 2) were included in the study. Left ventricular ejection fraction (LVEF), left atrial diameter (LAD), mitral annular systolic velocity (Sm), left ventricular global longitudinal strain (GLS), and left ventricular mass index (LVMI) values were recorded across four sessions, from pre-transplant to six months post-transplantation. Endomyocardial biopsy was performed for detailed examination of the myocardium in patients in Group 1 and Group 3, and cardiac magnetic resonance imaging (MRI) was performed in all three groups before transplantation. Results: In Group 1, LVEF, Sm, and left ventricular global longitudinal strain (LV-GLS) increased significantly, while LAD and LVMI decreased, all reaching normal levels. In contrast, no changes were observed in Group 3 and Group 2 (P < 0.01 for LVEF, P < 0.01 for GLS, P < 0.01 for LAD, and P < 0.01 for LVMI measurements). No differences in cardiac MRI and biopsy findings were observed between Group 1 and Group 3. Conclusion: Since myocardial function improved significantly and normalized in all patients with it has been demonstrated that UC can be reversible when treated with KT.