Table 3_Association of preoperative systemic inflammation with postoperative conduction block in TAVI patients.docx

BackgroundConduction 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.
MethodsThis 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.
ResultsPostoperative 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.
ConclusionPreoperative 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.

背景 传导阻滞（conduction block, CB）是经导管主动脉瓣植入术（transcatheter aortic valve implantation, TAVI）后常见的并发症。全身炎症可能在其发病过程中发挥作用，但相关证据较为有限。
方法 本前瞻性研究共纳入155例行经导管主动脉瓣植入术的患者。采用logistic回归、线性回归及限制性立方样条分析，对术前全身炎症标志物——包括全身免疫炎症指数（systemic immune-inflammation index, SII）、中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio, NLR）、血小板与淋巴细胞比值（platelet-to-lymphocyte ratio, PLR）以及淋巴细胞与单核细胞比值（lymphocyte-to-monocyte ratio, LMR）——与术后传导阻滞及心功能的相关性进行分析。
结果 术后传导阻滞的发生率为35.5%。术前较高的SII（优势比OR=1.0009；P=0.0289）、NLR（OR=1.1630；P=0.0253）与PLR（OR=1.0079；P=0.0065）均与传导阻滞风险升高显著相关，而术前较高的LMR则具有保护作用（OR=0.7435；P=0.0194）。LMR还与射血分数降低及左心室容积增加独立相关。性别亚组分析显示，女性群体中上述关联更为显著。
结论 术前全身炎症状态与经导管主动脉瓣植入术后的传导阻滞及心功能转归独立相关。基于炎症的生物标志物或可作为风险分层及围手术期规划的有效工具。