Key result
TAVI linked to ~33% lower functional MR grade within one month in severe AS.
Why the study?
The echocardiographic features and dynamics of functional mitral regurgitation in patients with severe aortic stenosis undergoing TAVI were not well characterized.
Does TAVI improve concomitant functional mitral regurgitation in patients with severe aortic stenosis?
Observational (n=79)
Does TAVI improve concomitant functional mitral regurgitation in patients with severe aortic stenosis?
Absolute Event Rate: 0.8% vs 1.2%
p-value: p=<0.001
TAVI significantly improves concomitant functional mitral regurgitation in patients with severe aortic stenosis early after the procedure, prior to left ventricular reverse remodeling.
May support deferring mitral valve intervention after TAVI in severe AS; leaves open durability and outcome impact pending prospective trials.
BACKGROUND: The aim of this study was to investigate the echocardiographic features of functional mitral regurgitation (MR) in patients with aortic stenosis (AS) pre- and post-trans catheter aortic valve implantation (TAVI). METHODS: The study subjects consisted of 79 patients with severe AS, who underwent TAVI. The echocardiographic parameters related to MR severity prior to TAVI and the change in these parameters and MR severity within one month after implantation were retrospectively evaluated. RESULTS: The mean left ventricular ejection fraction (LVEF) was 53 ± 12%, and the mean MR severity was 1.2 ± 0.7. Among the baseline parameters, age (p = 0.019, r = 0.264), LV mass (p = 0.017, r = 0.269), deceleration time (DT) (p = 0.019, r = -0.266), left atrial diameter (p = 0.003, r = 0.325), were related to pre-procedure MR severity. After TAVI, the grade of MR (1.2 ± 0.7 vs. 0.8 ± 0.6, p < 0.001) and MR duration (43 ± 19% vs. 31 ± 23%, p < 0.001) were significantly decreased. The grade of pre-procedural MR (p < 0.001) was a predictor of residual MR after TAVI. However, there was not a significant change in the left ventricular echocardiographic parameters after TAVI [LVEF (53 ± 12 vs. 52 ± 11, p = 0.285), and LV mass (302 ± 84 vs. 306 ± 76 g, p = 0.495)]. CONCLUSIONS: In patients with severe AS, functional MR is related to age, LV mass, DT and left atrial diameter. TAVI improves MR in these patients, even before LV remodelling occurs.
No takes yet. Share an insight, caveat, or question.
Şahinarslan et al. (2016) conducted an observational in Severe aortic stenosis with functional mitral regurgitation (n=79). Transcatheter aortic valve implantation (TAVI) vs. Pre-TAVI baseline was evaluated on Mitral regurgitation severity grade (p=<0.001). TAVI significantly reduced the grade of functional mitral regurgitation (from 1.2 to 0.8, p<0.001) and MR duration within one month in patients with severe aortic stenosis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: