Concomitant aortic regurgitation predicts better left ventricular reverse remodeling after transcatheter aortic valve replacement.

BMC Cardiovasc Disord

Department of Cardiology and Laboratory of Heart Valve Disease, West China Hospital, Sichuan University, #37 Guoxue Alley, Chengdu, 610041, PR China.

Published: July 2023


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Article Abstract

Background: We aim to determine predictors of inadequate left ventricular mass index (LVMi) regression at mid-term after transcatheter aortic valve replacement (TAVR), including the potential role of epicardial adipose tissue (EAT).

Methods: We retrospectively reviewed patients with both echocardiographic assessments and multi-slice computed tomography (MSCT) obtained one year after TAVR. The change of LVMi, the volume and the average CT attenuation of EAT from baseline to one-year follow-up was calculated. Patients were divided into two groups by the percentage change of LVMi at a cut-off of 15%.

Results: A total of 152 patients were included with a median age of 74 years (interquartile range [IQR] 69-78 years) and 56.6% being male. LVMi decreased (P < 0.0001) while EAT volume increased and the average CT attenuation decreased (both P < 0.0001) at one year. Baseline atrial fibrillation (P = 0.042), mitral regurgitation ≥ mild (P = 0.006), aortic regurgitation (AR) > mild (P = 0.001) and the change in the average CT attenuation of EAT (P = 0.026) were different between the decrease of LVMi ≥ 15% and < 15%. AR > mild at baseline was the only statistically significant predictor of a decrease of LVMi < 15% at one year (OR 0.33, 95% CI: 0.13 to 0.84, P = 0.021) in multivariate regression.

Conclusions: Concomitant more-than-mild AR might predict better left ventricular reverse remodeling regression after TAVR.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353111PMC
http://dx.doi.org/10.1186/s12872-023-03377-7DOI Listing

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