INTRODUCTION
Aortic stenosis (AS) is the most
common acquired valve disease in elderly patients (1), requiring valve
replacement either by surgery or catheter intervention (2) (3).
Transcatheter aortic valve replacement (TAVR) is becoming the preferred
approach to treat patients with severe AS (4). Nevertheless, despite
growing evidences show good clinical outcomes in AS patients undergoing
TAVR, conduction abnormalities (CAs) and the risk of permanent pacemaker
implantation (PPI) still rise concerns about TAVR safety. Indeed, it has
been recently reported that PPI incidence ranges from 6.6% to 34.8%
depending on the use of balloon expandable or self-expandable valves (5)
(6) (7).
It is well established that inflammation burden in AS plays a key role
in the progression from aortic sclerosis to calcification and that the
increased inflammatory activity is closely related to the hemodynamic
severity of the disease (8). Neutrophil/lymphocyte ratio (NLR) has been
proposed as a marker of inflammation and its ability to predict outcomes
has been tested in several cardiac diseases (9). In AS, NLR has been
shown to be related to the severity of calcific AS, left ventricular
(LV) disfunction (10), and to be a predictor of major adverse cardiac
events (MACE) (11).
Hence, in this retrospective analysis we aimed to investigate the
possible role of NLR, as readout of inflammatory state, in PPI in
patients with severe AS undergoing TAVR procedure.