Transcatheter aortic valve replacement and standard therapy in inoperable @entity1 with XXXX and low EF.

@entity1 @entity472 @entity1002
OBJECTIVES: The aims of this study were to evaluate the effect of left ventricular (LV) dysfunction on clinical outcomes after transcatheter aortic valve replacement (TAVR) and standard therapy for severe @entity472 ( @entity472 ) and to assess @entity1002 ( @entity1002 ) recovery and its impact on subsequent clinical outcomes. METHODS: Cohort B of the Placement of AoRtic TraNscathetER Valves trial randomised 342 inoperable @entity1 with severe @entity472 to TAVR or standard therapy. We defined @entity1002 as an @entity1002 <50% and @entity1002 improvement as an absolute increase in @entity1002 >= 10% at 30   days. RESULTS: Baseline @entity1002 did not affect survival after TAVR but was associated with increased cardiac mortality at 1 year with standard therapy (59.3% vs 45.8% with normal @entity1002 ; HR=1.71 (95% CI 1.08 to 2.71); p=0.02). In those with @entity1002 , @entity1002 improvement occurred in 48.7% and 30.4% of TAVR and standard therapy @entity1 , respectively (p=0.08), and was independently predicted by relative wall thickness and receipt of TAVR. @entity1002 improvement with standard therapy portended reduced all-cause mortality at 1   year (28.6% vs 65.6% without @entity1002 improvement; HR=0.32 (95% CI 0.11 to 0.93); p=0.03) but not at 2   years. CONCLUSIONS: In inoperable @entity1 with severe @entity472 , mild-to-moderate @entity1002 is associated with higher cardiac mortality with standard therapy but not TAVR. A subset of @entity1 undergoing standard therapy with @entity1002 demonstrates @entity1002 improvement and favourable 1-year but not 2-year survival. TAVR improves survival and should be considered the standard of care for inoperable @entity1 with @entity472 and @entity1002 >20%. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Unique Identifier #NCT00530894.
