Key result
TAVI linked to ~9% reduction in LVMI at 6 months.
Why the study?
Aortic stenosis induces left ventricular hypertrophy and remodeling, and the impact of TAVI on left ventricular mass over early and mid-term follow-up needed evaluation.
Does transcatheter aortic valve implantation reduce left ventricular mass in patients with severe aortic stenosis?
Cohort (n=75)
No
Does transcatheter aortic valve implantation reduce left ventricular mass in patients with severe aortic stenosis?
TAVI is associated with significant early and mid-term regression of left ventricular mass and improvement in ejection fraction in patients with severe aortic stenosis.
TAVI associated with early LVMI regression; hypothesis-generating for reverse remodeling and requires randomized confirmation before practice change.
BACKGROUND: Aortic stenosis (AS) induces pressure overload of the left ventricle (LV) and results in left ventricular hypertrophy. The remodeling of the LV in patients with AS is a com-plex process including structural and functional disturbances. After aortic valve replacement, reverse remodeling of LV begins. The aim of this study was to evaluate the impact of transcatheter aortic valve ımplantation (TAVI) on LV mass (LVM) in early and mid-term follow-ups after the procedure. METHODS AND RESULTS: We enrolled consecutive 75 patients who underwent successful TAVI. Transthoracic echocardiography was performed prior to TAVI and at hospital discharge, in the 1st month and 6th month of the follow-ups. The mean LV ejection fraction improved significantly after TAVI (54.2 ± 15.0% to 57.3 ± 11.7%, p < 0.001). There were no significant changes between the baseline and discharge mean LVM and LVM index values (LVMI; p = 0.1). However, LVMI decreased significantly in the 1st month of follow-up compared to baseline (123.3 ± 20.3 to 127.9 ± 21.3 g/m², respectively, p < 0.001). Also, significant regression of LVM was observed at the 1st month of follow-up compared to baseline (228.3 ± 33.5 g vs. 236.5 ± 34.2 g, respectively, p < 0.001). Furthermore, the significant regression in both of LVM and LVMI continued at 1st and 6th months of the follow-ups (p < 0.001). CONCLUSIONS: A significant regression of LVM was observed after TAVI. These changes may have prognostic value in patients with severe AS.
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Kasapkara et al. (2015) conducted a cohort in Severe aortic stenosis (n=75). Transcatheter aortic valve implantation (TAVI) vs. Baseline was evaluated on Left ventricular mass index (LVMI) at 1 month (p=<0.001). Transcatheter aortic valve implantation significantly reduced left ventricular mass index from 127.9 g/m2 at baseline to 123.3 g/m2 at 1 month and 116.5 g/m2 at 6 months (p < 0.001).
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