IMR Press / RCM / Volume 24 / Issue 8 / DOI: 10.31083/j.rcm2408243
Open Access Original Research
LDL-C: An Important Independent Risk Factor for New-Onset Heart Block in Patients with Severe Aortic Stenosis and Heart Failure after TAVR
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1 Department of Cardiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000 Yantai, Shandong, China
2 Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, 300070 Tianjin, China
3 School of Nursing and Health Studies, Hong Kong, Metropolitan University, 999077 Hong Kong, China
4 Kent and Medway Medical School, CT2 7FS Canterbury, UK
5 Department of Ultrasound, Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000 Yantai, Shandong, China
6 Department of Cardiovascular Surgery, Second Hospital of Tianjin Medical University, 300070 Tianjin, China
*Correspondence: drren@163.com (Faxin Ren)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(8), 243; https://doi.org/10.31083/j.rcm2408243
Submitted: 12 December 2022 | Revised: 31 March 2023 | Accepted: 20 April 2023 | Published: 24 August 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Transcatheter aortic valve replacement (TAVR) is an effective alternative treatment for patients with aortic stenosis (AS) who have intermediate to high surgical risk or who are inoperable. However, the incidence of conduction abnormalities is high after TAVR, which can reduce the effectiveness of the surgery. Our research objective is to explore the risk factors of new-onset conduction abnormalities after TAVR, providing reference value for clinical doctors to better prevent and treat conduction abnormalities. Methods: Patients who underwent TAVR were divided into those who developed heart block and those who did not. Baseline clinical characteristics, cardiac structural parameters, procedural characteristics, electrocardiogram (ECG) changes before and after TAVR ( = postoperative minus preoperative), and surgical complications were compared. Logistic regression was applied to identify significant risk factors for new-onset heart block. Results: We studied 93 patients, of whom 34.4% developed heart blocks. Univariate logistic regression showed that prior history of malignancy, atrial fibrillation, preoperative high-level total cholesterol and low-density lipoprotein cholesterol (LDL-C), HR, QRS interval, QT interval, and QTc interval were risk factors of new-onset heart block after TAVR. Multivariate analysis showed that preoperative high-level LDL-C and QRS interval remained significant independent risk factors after adjusting for potential confounds. Conclusions: Heart block is the most common complication of TAVR, and its significant independent risk factors include high-level LDL-C and QRS interval.

Keywords
heart block
heart failure
risk factors
severe aortic stenosis
transcatheter aortic valve replacement
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