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The impact of transcatheter aortic valve implantation on left ventricular performance and wall thickness - single-centre experience.

Stokłosa P, Szymański P, Dąbrowski M, Zakrzewski D, Michałek P, Orłowska-Baranowska E, El-Hassan K, Chmielak Z, Witkowski A, Hryniewiecki T - Postepy Kardiol Interwencyjnej (2015)

Bottom Line: The LV ejection fraction (LVEF) significantly increased in both short-term and long-term follow-up (57 ±14% vs. 59 ±13%, p < 0.001 and 56 ±14% vs. 60 ±12%, p < 0.001, respectively).The TAVI had an immediate beneficial effect on LVEF, LV walls thickness, and the incidence of msMR.The results of the procedure are comparable with those described in other centres.

View Article: PubMed Central - PubMed

Affiliation: Department of Valvular Heart Disease, Institute of Cardiology, Warsaw, Poland.

ABSTRACT

Introduction: Transcatheter aortic valve implantation (TAVI) is a treatment alternative for the elderly population with severe symptomatic aortic stenosis (AS) at high risk for surgical aortic valve replacement (SAVR).

Aim: To assess the impact of TAVI on echocardiographic parameters of left ventricular (LV) performance and wall thickness in patients subjected to the procedure in a single-centre between 2009 and 2013.

Material and methods: The initial group consisted of 170 consecutive patients with severe AS unsuitable for SAVR. Logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 21.73 ±12.42% and mean age was 79.9 ±7.5 years.

Results: The TAVI was performed in 167 (98.2%) patients. Mean aortic gradient decreased significantly more rapidly after the procedure (from 58.6 ±16.7 mm Hg to 11.9 ±4.9 mm Hg, p < 0.001). The LV ejection fraction (LVEF) significantly increased in both short-term and long-term follow-up (57 ±14% vs. 59 ±13%, p < 0.001 and 56 ±14% vs. 60 ±12%, p < 0.001, respectively). Significant regression of interventricular septum diameter at end-diastole (IVSDD) and end-diastolic posterior wall thickness (EDPWth) was noted in early (15.0 ±2.4 mm vs. 14.5 ±2.3 mm, p < 0.001 and 12.7 ±2.1 mm vs. 12.4 ±1.9 mm, p < 0.028, respectively) and late post-TAVI period (15.1 ±2.5 mm to 14.3 ±2.5 mm, p < 0.001 and 12.8 ±2.0 mm to 12.4 ±1.9 mm, p < 0.007, respectively). Significant paravalvular leak (PL) was noted in 21 (13.1%) patients immediately after TAVI and in 13 (9.6%) patients in follow-up (p < 0.001). Moderate or severe mitral regurgitation (msMR) was seen in 24 (14.9%) patients from the initial group and in 19 (11.8%) patients after TAVI (p < 0.001).

Conclusions: The TAVI had an immediate beneficial effect on LVEF, LV walls thickness, and the incidence of msMR. The results of the procedure are comparable with those described in other centres.

No MeSH data available.


Related in: MedlinePlus

Reduction in LV wall thickness after TAVI
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Figure 0003: Reduction in LV wall thickness after TAVI

Mentions: Statistically significant early decrease in maximal (96.0 ±25.3 mm Hg vs. 21.8 ±8.2 mm Hg, p < 0.001) and in mean aortic gradient (58.6 ±16.7 mm Hg vs. 11.9 ±4.9 mm Hg, p < 0.001) was observed (Figure 1). Also, early positive changes of LVEF were noted – there was a significant increase in LVEF in both short-term (57 ±14% vs. 59 ±13%, p < 0.001) and long-term (56 ±14% vs. 60 ±12%, p < 0.001) observation (Figure 2). Significant decreases in IVSDD and EDPWth were observed also in early post TAVI (15.0 ±2.4 mm vs. 14.5 ±2.3 mm, p < 0.001 and 12.7 ±2.1 mm vs. 12.4 ±1.9 mm, p < 0.028, respectively) and late post TAVI (15.1 ±2.5 mm vs. 14.3 ±2.5 mm, p < 0.001 and 12.8 ±2.0 mm vs. 12.4 ±1.9 mm, p < 0.007, respectively) period (Figure 3). The LVEDD decrease after TAVI in the first observations was non-significant (47.4 ±7.5 mm vs. 47.6 ±7.0 mm, p < 0.541) but was statistically significant during follow-up (47.3 ±7.6 mm vs. 46.1 ±7.5 mm, p < 0.030). In case of LVESD, the decrease was not significant either in short-term (31.3 ±9.0 mm vs. 30.0 ±8.4 mm, p < 0.062) or in long-term (30.9 ±8.4 vs. 30.1 ±7.9, p < 0.261) echocardiograms. Moderate/severe PL was observed in 21 (13.1%) patients before hospital discharge but in 13 (9.6%) patients during follow-up (p < 0.001, Figure 4). Significant MR was seen in 24 (14.9%) patients of the initial group but in 19 (11.8%) patients in an early and in late period after TAVI (p < 0.001, Figure 4).


The impact of transcatheter aortic valve implantation on left ventricular performance and wall thickness - single-centre experience.

Stokłosa P, Szymański P, Dąbrowski M, Zakrzewski D, Michałek P, Orłowska-Baranowska E, El-Hassan K, Chmielak Z, Witkowski A, Hryniewiecki T - Postepy Kardiol Interwencyjnej (2015)

Reduction in LV wall thickness after TAVI
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4372630&req=5

Figure 0003: Reduction in LV wall thickness after TAVI
Mentions: Statistically significant early decrease in maximal (96.0 ±25.3 mm Hg vs. 21.8 ±8.2 mm Hg, p < 0.001) and in mean aortic gradient (58.6 ±16.7 mm Hg vs. 11.9 ±4.9 mm Hg, p < 0.001) was observed (Figure 1). Also, early positive changes of LVEF were noted – there was a significant increase in LVEF in both short-term (57 ±14% vs. 59 ±13%, p < 0.001) and long-term (56 ±14% vs. 60 ±12%, p < 0.001) observation (Figure 2). Significant decreases in IVSDD and EDPWth were observed also in early post TAVI (15.0 ±2.4 mm vs. 14.5 ±2.3 mm, p < 0.001 and 12.7 ±2.1 mm vs. 12.4 ±1.9 mm, p < 0.028, respectively) and late post TAVI (15.1 ±2.5 mm vs. 14.3 ±2.5 mm, p < 0.001 and 12.8 ±2.0 mm vs. 12.4 ±1.9 mm, p < 0.007, respectively) period (Figure 3). The LVEDD decrease after TAVI in the first observations was non-significant (47.4 ±7.5 mm vs. 47.6 ±7.0 mm, p < 0.541) but was statistically significant during follow-up (47.3 ±7.6 mm vs. 46.1 ±7.5 mm, p < 0.030). In case of LVESD, the decrease was not significant either in short-term (31.3 ±9.0 mm vs. 30.0 ±8.4 mm, p < 0.062) or in long-term (30.9 ±8.4 vs. 30.1 ±7.9, p < 0.261) echocardiograms. Moderate/severe PL was observed in 21 (13.1%) patients before hospital discharge but in 13 (9.6%) patients during follow-up (p < 0.001, Figure 4). Significant MR was seen in 24 (14.9%) patients of the initial group but in 19 (11.8%) patients in an early and in late period after TAVI (p < 0.001, Figure 4).

Bottom Line: The LV ejection fraction (LVEF) significantly increased in both short-term and long-term follow-up (57 ±14% vs. 59 ±13%, p < 0.001 and 56 ±14% vs. 60 ±12%, p < 0.001, respectively).The TAVI had an immediate beneficial effect on LVEF, LV walls thickness, and the incidence of msMR.The results of the procedure are comparable with those described in other centres.

View Article: PubMed Central - PubMed

Affiliation: Department of Valvular Heart Disease, Institute of Cardiology, Warsaw, Poland.

ABSTRACT

Introduction: Transcatheter aortic valve implantation (TAVI) is a treatment alternative for the elderly population with severe symptomatic aortic stenosis (AS) at high risk for surgical aortic valve replacement (SAVR).

Aim: To assess the impact of TAVI on echocardiographic parameters of left ventricular (LV) performance and wall thickness in patients subjected to the procedure in a single-centre between 2009 and 2013.

Material and methods: The initial group consisted of 170 consecutive patients with severe AS unsuitable for SAVR. Logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 21.73 ±12.42% and mean age was 79.9 ±7.5 years.

Results: The TAVI was performed in 167 (98.2%) patients. Mean aortic gradient decreased significantly more rapidly after the procedure (from 58.6 ±16.7 mm Hg to 11.9 ±4.9 mm Hg, p < 0.001). The LV ejection fraction (LVEF) significantly increased in both short-term and long-term follow-up (57 ±14% vs. 59 ±13%, p < 0.001 and 56 ±14% vs. 60 ±12%, p < 0.001, respectively). Significant regression of interventricular septum diameter at end-diastole (IVSDD) and end-diastolic posterior wall thickness (EDPWth) was noted in early (15.0 ±2.4 mm vs. 14.5 ±2.3 mm, p < 0.001 and 12.7 ±2.1 mm vs. 12.4 ±1.9 mm, p < 0.028, respectively) and late post-TAVI period (15.1 ±2.5 mm to 14.3 ±2.5 mm, p < 0.001 and 12.8 ±2.0 mm to 12.4 ±1.9 mm, p < 0.007, respectively). Significant paravalvular leak (PL) was noted in 21 (13.1%) patients immediately after TAVI and in 13 (9.6%) patients in follow-up (p < 0.001). Moderate or severe mitral regurgitation (msMR) was seen in 24 (14.9%) patients from the initial group and in 19 (11.8%) patients after TAVI (p < 0.001).

Conclusions: The TAVI had an immediate beneficial effect on LVEF, LV walls thickness, and the incidence of msMR. The results of the procedure are comparable with those described in other centres.

No MeSH data available.


Related in: MedlinePlus