Structural Heart最新文献

{"title":"Safety of Same-Day Discharge After Elective Transcatheter Aortic Valve Implantation With Balloon- and Self-Expanding Valves: A Prospective Single-Center UK Study","authors":"Saif Memon MBBS ,&nbsp;Muntaser Omari MBBS ,&nbsp;Debbie Stewart BSc ,&nbsp;Hong Hong Chong MBBS ,&nbsp;Mohamed Ali MBBS ,&nbsp;Richard Edwards MBBS ,&nbsp;Rajiv Das MBBS ,&nbsp;Tim Cartlidge MBBS ,&nbsp;Azfar Zaman MBBS ,&nbsp;Mohamed Farag MBBS ,&nbsp;Mohammad Alkhalil DPhil","doi":"10.1016/j.shj.2025.100728","DOIUrl":"10.1016/j.shj.2025.100728","url":null,"abstract":"<div><h3>Background</h3><div>In patients undergoing transcatheter aortic valve implantation (TAVI), it is unclear whether same-day discharge (SDD) while adopting a device-agnostic approach is a safe strategy compared to non-SDD. We aim to compare TAVI patients who underwent SDD and non-SDD according to a predefined protocol.</div></div><div><h3>Methods</h3><div>This is a prospective single-center study of consecutive patients who were scheduled for elective TAVI procedures. The primary endpoint was the composite of death, vascular access–related complications, any bleeding requiring hospitalization, all stroke (or transient ischemic attack), or new permanent pacemaker implantation at 30 days defined according to the Valve Academic Research Consortium 3 criteria.</div></div><div><h3>Results</h3><div>Out of 472 consecutive patients who underwent elective TAVI, 289 patients did not report procedural complications, of whom 60 (21%) were discharged on the same day. The mean age was 81 ± 7 years, with 60% of the cohort being male. There were no significant differences in clinical characteristics among patients according to their in-hospital SDD strategy. Pre-existing left or right bundle branch block was comparable between the 2 groups. The primary endpoint was reported in 2.8% of the entire cohort, with no significant difference between patients who underwent SDD TAVI and those who did not (1.7% vs. 3.1%, respectively, <em>p</em> = 0.56). Patients who had a self-expanding valve had a comparable primary endpoint to those who had a balloon-expandable valve, including readmission for a permanent pacemaker.</div></div><div><h3>Conclusions</h3><div>SDD TAVI is a safe and feasible approach in patients who underwent an elective uneventful procedure, including patients who received self-expanding valves. Future studies are required to support these findings.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 11","pages":"Article 100728"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Valve in Valve After Transcatheter Aortic Valve Replacement With SAPIEN 3 Valves and Surgical Aortic Valve Replacement","authors":"Tej Sheth MD ,&nbsp;Warkaa Al-Shamkani MD ,&nbsp;Ahmed Makhdoum MD ,&nbsp;Jorge Chavarria Viquez MD ,&nbsp;Muhammad Suleman MD ,&nbsp;Alexander Dick MD ,&nbsp;Janarthanan Sathananthan MD ,&nbsp;David Wood MD ,&nbsp;Neil Fam MD ,&nbsp;Hatim AlRaddadi MD ,&nbsp;Madhu K. Natarajan MD ,&nbsp;James L. Velianou MD","doi":"10.1016/j.shj.2025.100729","DOIUrl":"10.1016/j.shj.2025.100729","url":null,"abstract":"<div><h3>Background</h3><div>The feasibility of transcatheter intervention after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) is important for the lifetime management of aortic stenosis.</div></div><div><h3>Methods</h3><div>A multicenter study was conducted of 4 patient groups: (1) TAVR using SAPIEN 3 at ≤90% implant depth, (2) TAVR using SAPIEN 3 at &gt;90% implant depth, (3) SAVR, and (4) SAVR with aortic root enlargement (ARE) who underwent post-treatment computed tomography. Future TAVR was classified as challenging if the simulated neo-skirt was at or above the coronary ostia and &lt;4 mm away from the coronary ostia and/or &lt;2 mm from the sinotubular junction or aortic wall.</div></div><div><h3>Results</h3><div>A total of 245 patients were evaluated (n = 117 TAVR using SAPIEN 3 at ≤90% implant depth, n = 66 TAVR using SAPIEN 3 at &gt;90% implant depth, n = 31 SAVR, n = 31 SAVR with ARE). The proportion of patients where the simulated neo-skirt was below both coronary arteries was the highest in TAVR with implantation depth ≤90% (47.0%), intermediate in TAVR using SAPIEN 3 at &gt;90% implant depth (22.7%) and SAVR (12.9%), and the lowest in SAVR with ARE (0%), (<em>p</em> &lt; 0.001). Challenging anatomy for future TAVR was identified in 9.8% of TAVR at ≤90% implant depth, 28.8% of TAVR at &gt;90% implant depth, 22.6% of SAVR, and 29.0% of SAVR with ARE (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Based on post-treatment computed tomography analysis, TAVR with SAPIEN 3 at implant depth ≤90% was the most repeatable initial intervention whereas SAVR with ARE did not improve the feasibility of future TAVR.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 11","pages":"Article 100729"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Prior Q-Wave Myocardial Infarction in Transcatheter Aortic Valve Replacement Patients With Reduced Ejection Fraction","authors":"Siddhartha Mengi MD ,&nbsp;Marina Urena MD, PhD ,&nbsp;Gabriela Veiga-Fernandez MD, PhD ,&nbsp;Alberto Alperi MD, PhD ,&nbsp;Luis Nombela-Franco MD, PhD ,&nbsp;Victoria Vilalta MD, PhD ,&nbsp;Ander Regueiro MD, PhD ,&nbsp;Jules Mesnier MD ,&nbsp;Victor Fradejas-Sastre RN, PhD ,&nbsp;Pablo Avanzas MD, PhD ,&nbsp;Ricardo Ortiz Lozada MD ,&nbsp;Elena de Oliveira-Cañedo MD ,&nbsp;Giovanni Occhipinti MD ,&nbsp;Pedro Cepas-Guillén MD, PhD ,&nbsp;Marisa Avvedimento MD ,&nbsp;Josep Rodés-Cabau MD, PhD","doi":"10.1016/j.shj.2025.100731","DOIUrl":"10.1016/j.shj.2025.100731","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery disease is prevalent in transcatheter aortic valve replacement (TAVR) patients, but the specific impact of prior Q-wave myocardial infarction (QWMI), a marker of transmural infarction, remains underexplored. This study evaluated the clinical impact of QWMI in TAVR patients with left ventricular ejection fraction (LVEF) ​&lt; ​50%.</div></div><div><h3>Methods</h3><div>Multicenter study including 1172 consecutive patients undergoing TAVR with contemporary devices, stratified according to prior QWMI. The primary outcome was all-cause mortality or heart failure hospitalization (HFH) over a median follow-up of 3 (1-4) years. Secondary endpoints included changes in LVEF and independent predictors of adverse outcomes.</div></div><div><h3>Results</h3><div>Prior QWMI was present in 106 (9.0%) patients. Those with QWMI were younger (77.3 vs 80.6 years; <em>p</em> ​&lt; ​0.001) and had lower baseline LVEF (36.3 vs. 38.3%; <em>p</em> ​= ​0.048). Unadjusted analysis showed higher all-cause mortality (49.1 vs 31.7%; <em>p</em> ​&lt; ​0.001) and combined death or HFH (54.8 vs 36.7%; <em>p</em> ​&lt; ​0.001). LVEF improvement at 30 days was attenuated in QWMI patients, particularly with anterior MI. After adjustment, QWMI was not independently associated with mortality or combined death/HFH. Chronic kidney disease (hazard ratio: 1.26; <em>p</em> ​= ​0.042) and permanent atrial fibrillation (hazard ratio: 1.30; <em>p</em> ​= ​0.013) were independent predictors of adverse outcomes.</div></div><div><h3>Conclusions</h3><div>Up to 1 out of 10 TAVR patients with reduced LVEF had prior QWMI, which was associated with impaired LVEF recovery, especially in those with anterior QWMI, and worse clinical outcomes at 3-year follow-up, largely driven by comorbidities. These findings underscore the importance of advanced preprocedural imaging, tailored therapeutic strategies, and integrated multidisciplinary care to enhance outcomes in this high-risk TAVR population.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 11","pages":"Article 100731"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Same-Day Discharge Post-Transcatheter Aortic Valve Implantation: An Emerging Paradigm in Aortic Valve Intervention?","authors":"Ander Regueiro MD, PhD ,&nbsp;Amr Abdelrahman MBBS","doi":"10.1016/j.shj.2025.100733","DOIUrl":"10.1016/j.shj.2025.100733","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 11","pages":"Article 100733"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of Prosthesis Oversizing in Self-Expanding Intra-Annular Transcatheter Aortic Valve Replacement","authors":"Andrea Ruberti MD ,&nbsp;Giovanni Occhipinti MD ,&nbsp;Matias Mon Noboa MD ,&nbsp;Luis Nombela-Franco MD, PhD ,&nbsp;Daijiro Tomii MD ,&nbsp;Thomas Pilgrim MD, PhD ,&nbsp;Manel Sabaté MD, PhD ,&nbsp;Endaitz Estebanez ,&nbsp;Nieves Gonzalo MD, PhD ,&nbsp;Pilar Jimenez-Quevedo MD, PhD ,&nbsp;Gabriela Tirado-Conte MD, PhD ,&nbsp;Laura Sanchis MD, PhD ,&nbsp;Omar Abdul-Jawad Altisent MD, PhD ,&nbsp;Eduardo Flores-Umanzor MD, PhD ,&nbsp;Francisco Campelo-Parada MD, PhD ,&nbsp;Xavier Freixa MD, PhD ,&nbsp;Ander Regueiro MD, PhD","doi":"10.1016/j.shj.2025.100730","DOIUrl":"10.1016/j.shj.2025.100730","url":null,"abstract":"<div><h3>Background</h3><div>Among patients undergoing transcatheter aortic valve replacement (TAVR), valve sizing is essential to guarantee procedural success and long-term durability of transcatheter heart valves (THVs). The optimal sizing strategy for self-expanding (SE) intra-annular THVs remains unclear. The aim of this study is to evaluate the impact of prosthesis oversizing on procedural and clinical outcomes in patients undergoing TAVR with the Portico and Navitor THVs.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter study included patients who underwent TAVR with SE intra-annular THVs between October 2017 and September 2024. Patients were stratified by the median oversizing value (14%) into low- (≤14%) and high- (&gt;14%) oversizing groups. The primary endpoint was technical success. Secondary outcomes included 30-day device success, permanent pacemaker implantation, cardiovascular mortality, heart failure–related hospitalization, and valve dysfunction at 12 months.</div></div><div><h3>Results</h3><div>A total of 400 patients (mean age 83.0 ​± ​6.0 years; 65.8% female) were included. Technical success was higher in the low-oversizing group (96.7 vs. 92.1%; <em>p</em> ​= ​0.048). Valve embolization occurred only in the high-oversizing group (0 vs. 2.1%; <em>p</em> ​= ​0.035). No significant differences were observed in 30-day device success (93.0 vs. 88.3%; <em>p</em> ​= ​0.171) and moderate-to-severe paravalvular regurgitation (2.9 vs. 1.8%; <em>p</em> ​= ​0.724). No differences emerged in permanent pacemaker implantation rates (24.5 vs. 25.7%; <em>p</em> ​= ​0.712). At 12 months, cardiovascular mortality (4.6 vs. 4.9%; <em>p</em> = 0.884) and heart failure hospitalization rates (6.9 vs. 4.9%; <em>p</em> = ​0.497) were similar.</div></div><div><h3>Conclusions</h3><div>In patients undergoing TAVR with SE intra-annular THVs, low-oversizing (≤14%) was associated with higher technical success and fewer valve-related complications.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 11","pages":"Article 100730"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Transcatheter Edge-to-Edge Mitral Valve Repair in Hypertrophic Cardiomyopathy: A Patient-Level Meta-Analysis","authors":"Lorraine Mascarenhas DO ,&nbsp;Gloria Yang BS ,&nbsp;Alok Sharma MD ,&nbsp;Stefan Bertog MD ,&nbsp;Scott Hubers MD ,&nbsp;Selcuk Adabag MD, MS","doi":"10.1016/j.shj.2025.100664","DOIUrl":"10.1016/j.shj.2025.100664","url":null,"abstract":"<div><h3>Background</h3><div>Hypertrophic cardiomyopathy (HCM) is commonly associated with left ventricular outflow tract (LVOT) obstruction and mitral regurgitation (MR). Transcatheter edge-to-edge repair (TEER) of the mitral valve has been introduced as a therapeutic alternative for individuals with LVOT obstruction and concurrent MR, but there are insufficient outcome data. We aim to perform a systematic review and patient-level meta-analysis of the studies reporting the outcomes of TEER of the mitral valve in HCM.</div></div><div><h3>Methods</h3><div>Original studies published in PubMed and Google Scholar were included if ​≥1 of the following pre- and post-TEER measures were reported: peak resting or provoked LVOT gradients, MR grade, mitral valve gradient, or New York Heart Association (NYHA) functional class. One unpublished case from the Minneapolis Veterans Affairs Medical Center was also included.</div></div><div><h3>Results</h3><div>Nineteen publications and 37 patients (mean age 70.1 [±15.2] years, 50% male, mean follow-up time of 9.2 [±6.4] months) were analyzed. Compared to baseline measurements, there was a significant reduction in the mean peak resting and provoked LVOT gradients (69.2 [±40.3] mmHg vs. 11.7 [±8.6] mmHg and 98.2 [±53.4] mmHg vs. 14.1 [±13.9] mmHg, respectively), median MR grade (4.0 [3.0-4.0] vs. 1.0 [1.0-1.0]), and proportion of patients with an NYHA functional class ≥3 (100 vs. 7%) post-TEER (all <em>p</em> &lt; 0.001). There was a significant increase in mean mitral valve gradients post-TEER (2.2 [±1.0] mmHg vs. 4.3 [±1.3] mmHg, <em>p</em> &lt; ​0.001).</div></div><div><h3>Conclusions</h3><div>TEER can be an effective therapeutic option for improving LVOT obstruction, MR severity, and NYHA functional class in patients with HCM.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 11","pages":"Article 100664"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aims & Scope","authors":"","doi":"10.1016/S2474-8706(25)00360-4","DOIUrl":"10.1016/S2474-8706(25)00360-4","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 11","pages":"Article 100768"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Expandable Transcatheter Aortic Valves in Patients With Small Aortic Annulus: The SWEDEHEART Registry","authors":"Antros Louca MD ,&nbsp;Anna Myredal MD, PhD ,&nbsp;Monér Alchay MD ,&nbsp;Henrik Hagström MD, PhD ,&nbsp;Dan Ioanes MD, PhD ,&nbsp;Stefan James MD, PhD ,&nbsp;Sasha Koul MD, PhD ,&nbsp;Araz Rawshani MD, PhD ,&nbsp;Björn Redfors MD, PhD ,&nbsp;Andreas Rück MD, PhD ,&nbsp;Kristofer Skoglund MD, PhD ,&nbsp;Sebastian Völz MD, PhD ,&nbsp;Petur Petursson MD, PhD ,&nbsp;Truls Råmunddal MD, PhD ,&nbsp;Oskar Angerås MD, PhD","doi":"10.1016/j.shj.2025.100680","DOIUrl":"10.1016/j.shj.2025.100680","url":null,"abstract":"<div><h3>Background</h3><div>Small aortic annulus is associated with poorer hemodynamic outcomes in transcatheter aortic valve replacement (TAVR). In these cases, supra-annular (SA) self-expandable valves (SEVs) may offer better results than intra-annular SEVs (IA SEVs). This study evaluated clinical and hemodynamic outcomes for SA SEVs (Evolut valves, Acurate valves) and IA SEVs (Portico/Navitor valves).</div></div><div><h3>Methods</h3><div>We analyzed data from patients who underwent TAVR in Sweden between 2013 and 2022 with an annular diameter ≤23 mm, using inverse probability of treatment weighting. Endpoints included mortality, device, and technical success as per Valve Academic Research Consortium 3 definitions. Other endpoints were the incidence of post-TAVR mean or peak gradients over 20 and 40 mmHg, respectively, significant paravalvular leakage, new pacemaker implantation, and postprocedural aortic valve gradients.</div></div><div><h3>Results</h3><div>The study included 1068 patients, with a median age of 81.2 years, and 88% were women. After inverse probability of treatment weighting adjustment, no differences were observed in the outcomes apart from a marginally lower risk of postprocedural mortality in the Portico/Navitor valves compared to the Evolut valves (adjusted odds ratio: 0.99; <em>p</em> ​= ​0.05; 95% CI: 0.98-1.00). Hemodynamically, the Evolut valves showed the lowest mean gradients, followed by the Portico/Navitor valves and the Acurate valves (7.97 vs 9.02 mmHg vs. 0.84 mmHg, respectively, <em>p</em> ​&lt; ​0.001; 95% CI: 0.35-1.00).</div></div><div><h3>Conclusions</h3><div>SA and IA SEVs show comparable clinical outcomes and excellent hemodynamic performance in patients with small aortic annuli. Further studies, including randomized trials, are needed to provide clearer guidance on valve selection.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"9 11","pages":"Article 100680"},"PeriodicalIF":2.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Damage Staging in Moderate or Greater Aortic Regurgitation: A New Framework for Risk Stratification","authors":"Francisco B. Alexandrino MD ,&nbsp;Ian Persits DO ,&nbsp;Joseph Hajj MD ,&nbsp;Ziad Zalaquett MD ,&nbsp;V. Karthik MD ,&nbsp;Travis Howard MD ,&nbsp;Vincent Chen MD ,&nbsp;Samir R. Kapadia MD ,&nbsp;Serge C. Harb MD ,&nbsp;Rishi Puri MD, PhD","doi":"10.1016/j.shj.2025.100748","DOIUrl":"10.1016/j.shj.2025.100748","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac damage staging is an established prognostic tool in aortic stenosis, and an initial application to aortic regurgitation (AR) showed prognostic relevance, mainly in advanced stages. No dedicated framework currently exists for AR. We aimed to characterize the extent and prognostic implications of multistructural cardiac damage in patients with moderate or greater AR.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 432 adult patients with ≥ moderate AR who underwent transthoracic echocardiography at Cleveland Clinic between 2008 and 2021. Cardiac damage was staged hierarchically from no damage (stage 0) to right ventricular dysfunction (stage 3) based on echocardiographic assessment of left ventricular (LV) global longitudinal strain, LV ejection fraction, chamber dimensions, valvular abnormalities, pulmonary pressures, and right ventricular function. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization.</div></div><div><h3>Results</h3><div>Over a median follow-up of 5.2 years (interquartile range, 1.9–9.3 years), advancing cardiac damage stage was associated with worsening LV function, progressive atrial and ventricular remodeling, and elevated pulmonary pressures (<em>p</em> &lt; 0.001 for all trends). Five-year cumulative incidence of the primary endpoint increased from 3.8% in stage 0 (n = 28), 17.3% in stage 1 (n = 101), 26.2% in stage 2 (n = 210) to 60.7% in stage 3 (n = 93). In multivariable Cox analysis, each stage increment portended a significantly higher risk of adverse outcomes (hazard ratio 2.1 per stage; 95% CI, 1.6–2.6; <em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>In patients with moderate or greater AR, the burden of cardiac damage incrementally stratified long-term risk. A dedicated staging model specific to AR may refine prognostic assessment and support earlier aortic valve interventions.</div></div>","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 1","pages":"Article 100748"},"PeriodicalIF":2.8,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finerenone in Patients Undergoing TAVR for Nonrheumatic Aortic Stenosis: Insights From a Real-World Cohort","authors":"Faysal Massad MD ,&nbsp;Osamah Badwan MD ,&nbsp;Akiva Rosenzveig MD ,&nbsp;Fawzi Zghyer MD ,&nbsp;Zaid Shahrori MD ,&nbsp;Issam Motairek MD ,&nbsp;Taha Hatab MD ,&nbsp;Radwan Alkhatib MD ,&nbsp;Samir Kapadia MD","doi":"10.1016/j.shj.2025.100751","DOIUrl":"10.1016/j.shj.2025.100751","url":null,"abstract":"","PeriodicalId":36053,"journal":{"name":"Structural Heart","volume":"10 3","pages":"Article 100751"},"PeriodicalIF":2.8,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}