Stenosis is a common disease affecting 5% of the elderly population. It is associated with hospitalizations, poor quality of life, and mortality.
The association between severe aortic stenosis (SAS) and hypertrophic cardiomyopathy (HCM) is increasingly frequent.
Currently, the available information on this scenario is limited and comes mainly from small registries or the analysis conducted by Mhanna et al., who compared transcatheter aortic valve replacement (TAVR) with surgery in this patient group. The results showed that TAVR was associated with lower in-hospital mortality, fewer complications, reduced need for vasoactive drugs, lower incidence of cardiogenic shock, and a shorter hospital stay.
Researchers conducted a meta-analysis including 1095 patients with SAS and HCM.
Patients with HCM experienced the following:
- Five times higher mortality rates (odds ratio [OR] 5.79; 95% confidence interval [CI]: 3.38-9.91, p <0.0001; I² = 85%).
- Four times higher incidence of cardiogenic shock (OR 4.55; 95% CI: 3.40-6.08, p <0.0001; I² = 48%).
- Higher incidence of vascular complications (OR 2.10; 95% CI: 1.27-3.47, p = 0.004; I² = 14%).
- Increased renal failure (OR 1.80; 95% CI: 1.36-2.40, p <0.0001; I² = 64%).
- Greater risk of aortic dissection (OR 4.95; 95% CI: 3.17-7.74, p <0.0001; I² = 0%).
There were no significant differences in the incidence of atrioventricular (A-V) block, need for permanent pacemaker, or bleeding events.
Conclusion
In patients with severe aortic stenosis and associated hypertrophic cardiomyopathy, TAVR was linked to a higher incidence of mortality, cardiogenic shock, aortic dissection, vascular complications, renal failure, and an increased need for mechanical ventilation compared to those without hypertrophic cardiomyopathy.
Original Title: Transcatheter Aortic Valve Replacement in Hypertrophic Cardiomyopathy: A Systematic Review and Meta‐ Analysis.
Reference: Ashraf Ahmed, et al. Catheterization and Cardiovascular Interventions, 2025; 105:754–760 https://doi.org/10.1002/ccd.31367.
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