Symptomatic Response and Cardiac Remodelling After TAVI: Insights from AI-Powered Echocardiographic Analysis

This study explored whether symptomatic improvement following transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis is reflected in measurable changes in cardiac structure and function.

To assess this, echocardiographic images taken at baseline and 6 to 18 months post-TAVI were analysed using Us2.ai's automated, validated deep learning workflow, enabling consistent and objective quantification of key echocardiographic parameters at scale.

While patients showed substantial symptomatic improvement at one year, only modest changes in echocardiographic parameters were observed. Notably, symptomatic improvement was not associated with improvement in echocardiographic measures of cardiac structure and function, a finding that challenges assumptions about the relationship between patient-reported outcomes and structural cardiac changes post-TAVI.

Key Findings

  • Symptomatic improvement at 1 year post-TAVI was not statistically associated with improvement in echocardiographic measures of cardiac structure and function, despite substantial patient-reported gains, challenging the assumption that the two align.
  • The study analysed echocardiograms from baseline and 6 to 18 months post-TAVI across a multicentre cohort using Us2.ai's fully automated deep learning workflow, enabling consistent longitudinal quantification at scale.
  • Only modest changes in echocardiographic parameters were observed overall, suggesting that structural cardiac remodelling after TAVI is more limited than symptomatic response implies.
  • The findings have direct implications for clinical follow-up protocols: patient-reported outcomes and echocardiographic markers should be treated as independent measures of TAVI benefit rather than interchangeable surrogates.

 

Venema, C. S., Bergeijk, V., Plekkenpol, L. H., Tromp, J., W Ouwerkerk, Hummel, Y. M., Krikken, J. A., Der, V., Den, V., Douglas, Y. L., E Lipsic, Voors, A. A., & Wykrzykowska, J. J. (2024). Discordance between symptomatic response and changes in cardiac structure and function one year after transcatheter aortic valve implantation. European Heart Journal, 45(Supplement_1). https://doi.org/10.1093/eurheartj/ehae666.2464