Acute Reverse Remodelling After Transcatheter Aortic Valve Implantation: A Link Between Myocardial Fibrosis and Left Ventricular Mass Regression

Dobson, Laura E; Musa, Tarique A; Uddin, Akhlaque; Fairbairn, Timothy A.; Swoboda, Peter; Erhayiem, Bara; Foley, James R.; Garg, Pankaj; Haaf, Philip; Fent, Graham; Malkin, Christopher J.; Blackman, Daniel J.; Plein, Sven; Greenwood, John P

doi:10.1016/j.cjca.2016.04.009

Cited by 34 publications

(37 citation statements)

References 29 publications

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“…An immediate reduction in indexed LV mass was also seen, a finding also seen in previous studies, both with TAVR and surgical replacement [15][16][17]. A correlation between time of performance of the second echocardiographic examination and LV mass reduction could not be found (p = 0.1772).…”

Section: Vanesa Cristina Lozano Granero Et Al Left Ventricular Mechsupporting

confidence: 51%

Immediate improvement of left ventricular mechanics following transcatheter aortic valve replacement

et al. 2018

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Section: Vanesa Cristina Lozano Granero Et Al Left Ventricular Mechsupporting

confidence: 51%

Immediate improvement of left ventricular mechanics following transcatheter aortic valve replacement

et al. 2018

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“…However, the majority of patients had an LVEF ≥50% and, it is unlikely that these patients had a burden of cardiac fibrosis that limited LV mass regression. 35 Bias may have also influenced our findings, given the study was not blinded to valve group. However, the sonographers and echocardiologists evaluating these studies were unaware of this particular research question.…”

Section: Discussionmentioning

confidence: 81%

A Paradox between LV Mass Regression and Hemodynamic Improvement after Surgical and Transcatheter Aortic Valve Replacement

et al. 2017

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“…In this study, a worse pre-procedural GLS was significantly associated with clinical events after TAVI, implying that potential LV systolic dysfunction due to LV geometric deformation before TAVI may influence the prognosis after TAVI. LV fibrosis was an independent predictor of mortality for patients with severe aortic stenosis [ 24 – 27 ]. Furthermore, worse GLS was also associated with interstitial fibrosis in an animal model of hypertensive heart failure [ 28 ], thereby suggesting that pre-procedural GLS could be a predictor of clinical events after TAVI.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of pre-procedural left ventricular strain for clinical events after transcatheter aortic valve implantation

et al. 2018

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BackgroundTranscatheter aortic valve implantation (TAVI) is an alternative therapy for surgically high-risk patients with severe aortic stenosis (AS). Although TAVI improves survival of patients with severe AS, the mechanism of this effect remains to be clarified. We investigated the effects of TAVI on left ventricular (LV) function and identified the predictive parameters for cardiac events after TAVI.Methods and resultsWe studied 128 patients with severe symptomatic AS who underwent TAVI. Echocardiographic assessments were performed before and after TAVI. In addition to the conventional echocardiographic parameters such as LV ejection fraction (LVEF) and LV mass index (LVMI), the LV global longitudinal strain (GLS) and early diastolic peak strain rate (SR_E) using two-dimensional speckle tracking echocardiography were also evaluated. All patients were assessed for clinical events including major adverse cardiac events and stroke according to Valve Academic Research Consortium-2 criteria. GLS, early diastolic peak velocity (eʹ), aortic regurgitation (AR) severity, and SR_E were significantly improved after TAVI. Thirteen patients had an event during the observational period of 591 days (median). Patients with events had higher LVMI, more severe AR, and worse GLS compared to those without events. Furthermore, receiver-operating curve analysis revealed that GLS was the strongest predictor for clinical events (p = 0.009; area under the curve, 0.73).ConclusionPreoperative LV geometric deformation and dysfunction, as a consequence of the cumulative burden of pressure overload, improved after TAVI and could predict cardiac events after TAVI.

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Acute Reverse Remodelling After Transcatheter Aortic Valve Implantation: A Link Between Myocardial Fibrosis and Left Ventricular Mass Regression

Cited by 34 publications

References 29 publications

Immediate improvement of left ventricular mechanics following transcatheter aortic valve replacement

Immediate improvement of left ventricular mechanics following transcatheter aortic valve replacement

A Paradox between LV Mass Regression and Hemodynamic Improvement after Surgical and Transcatheter Aortic Valve Replacement

Prognostic value of pre-procedural left ventricular strain for clinical events after transcatheter aortic valve implantation

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