Changes in Pulmonary Function Following TAVR: A Prospective Study Using Body Plethysmography

Transcatheter aortic valve replacement (TAVR) is an important treatment option for patients with severe aortic stenosis (AS) at high surgical risk. Pulmonary function abnormalities are frequently observed in heart failure (HF),  prompting investigation into the impact of TAVR on lung function.

To assess the impact of TAVR on lung function parameters measured by body plethysmography.

A prospective study included 204 patients with severe symptomatic AS who underwent TAVR between December 2022 and July 2024 at the Heart Center Bonn. Body plethysmography tests were conducted before the procedure and three months after TAVR. Primary outcomes were changes in total lung capacity (TLC), forced expiratory volume in first second (FEV1), and diffusing capacity of the lungs for carbon monoxide (DLCO).

Post-TAVR, no significant changes were observed in TLC (p = 0.693) or vital capacity (VC) (p = 0.684). However, there were significant improvements in the Tiffeneau index (p < 0.001) and FEV1 (baseline: 85.1 ± 24.7% vs. follow-up: 87.3 ± 25.2%; p = 0.037). Additionally, significant increases were found in DLCO adjusted for body surface area (DLCO/SB; 61.0 ± 27.5% vs. 68.4 ± 39.8%; p = 0.023) and alveolar volume (DLCO/VA, 76.2 ± 22.2% vs. 81.5 ± 19.3%; p < 0.001). 

TAVR leads to significant improvements in obstructive lung function parameters (Tiffeneau index and FEV1) and gas exchange (DLCO), suggesting that TAVR may reverse pulmonary structural remodelling associated with heart failure.