Association of preoperative systemic inflammation with postoperative conduction block in TAVI patients

经导管主动脉瓣置换术(TAVI)患者术前全身炎症与术后传导阻滞的相关性

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Abstract

BACKGROUND: Conduction block (CB) is a frequent complication following transcatheter aortic valve implantation (TAVI). Systemic inflammation may play a role in its development, but evidence is limited. METHODS: This prospective study included 155 patients who underwent TAVI. Preoperative systemic inflammation markers-including systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)-were analyzed in relation to postoperative conduction block and cardiac function using logistic and linear regression models, as well as restricted cubic spline analysis. RESULTS: Postoperative conduction block occurred in 35.5% of patients. Higher preoperative SII (OR = 1.0009; P = 0.0289), NLR (OR = 1.1630; P = 0.0253), and PLR (OR = 1.0079; P = 0.0065) were significantly associated with increased CB risk, while higher LMR was protective (OR = 0.7435; P = 0.0194). LMR was also independently associated with reduced ejection fraction and increased left ventricular volume. Gender subgroup analysis showed stronger associations in females. CONCLUSION: Preoperative systemic inflammation is independently associated with conduction block and cardiac function outcomes after TAVI. Inflammation-based biomarkers may serve as useful tools for risk stratification and perioperative planning.

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