Left Ventricular Hypertrophy Regression Following Transcatheter Aortic Replacement: A Comparison of Self-Expanding Versus Balloon-Expandable Prostheses.

Autor: Azemi T; Department of Cardiology, Hartford Healthcare Heart & Vascular Institute, Hartford Hospital, Hartford, Connecticut., Ahmed F; Department of Cardiology, Hartford Healthcare Heart & Vascular Institute, Hartford Hospital, Hartford, Connecticut., Sadiq I; Department of Cardiology, Hartford Healthcare Heart & Vascular Institute, Hartford Hospital, Hartford, Connecticut., Duvall WL; Department of Cardiology, Hartford Healthcare Heart & Vascular Institute, Hartford Hospital, Hartford, Connecticut., McMahon S; Department of Cardiology, Hartford Healthcare Heart & Vascular Institute, Hartford Hospital, Hartford, Connecticut., Mather JF; Department of Research Administration, Hartford Hospital, Hartford, Connecticut., Hashim SW; Department of Cardiac Surgery, Hartford HealthCare Heart & Vascular Institute, Hartford Hospital, Hartford, Connecticut., McKay RG; Department of Cardiology, Hartford Healthcare Heart & Vascular Institute, Hartford Hospital, Hartford, Connecticut. Electronic address: Raymond.mckay@hhchealth.org.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2024 Dec 01; Vol. 232, pp. 65-71. Date of Electronic Publication: 2024 Sep 25.
DOI: 10.1016/j.amjcard.2024.09.019
Abstrakt: There are limited reports on the impact of prosthesis-patient mismatch (PPM) on the regression of left ventricular hypertrophy (LVH) after transcatheter aortic valve replacement (TAVR). We compared the relative effects of supra-annular, self-expanding (SE) versus intra-annular, balloon-expandable (BE) prostheses on TAVR LVH regression. Regression of left ventricular mass index (LVMi) was evaluated in 168 consecutive TAVR patients, including 60 treated with SE valves (Evolut series) and 108 treated with BE valves (Sapien 3). All patients had LVH determined at baseline by echocardiography and had repeat LVMi measurements at a mean follow-up time of 707 ± 528 days. SE patients were more likely female (68.3% vs 46.3%, p = 0.007), but otherwise, the 2 cohorts did not differ with respect to baseline demographics and Society of Thoracic Surgeons risk score. SE patients had a higher effective orifice area indexed to body surface area after TAVR (0.98 ± 0.29 vs 0.86 ± 0.25 cm²/m², p = 0.006), with lower mean aortic valve gradients (9.9 ± 6.5 vs 12.8 ± 5.8 mm Hg, p = 0.003) and a lower prevalence of moderate/severe PPM (33.3% vs 49.1%, p = 0.049). On follow-up, changes in LVMi were similar between the SE and BE groups, with similar absolute changes in LVMi (19.2 ± 26.8 vs 21.9 ± 31.7 g/m 2 , p = 0.578) and relative LVMi decrease (14.0 ± 19.5 vs 16.2% ± 24.2%, p = 0.547). No difference in LVMi regression was also noted comparing combined SE/BE patients with moderate/severe PPM versus those without PPM. In conclusion, despite differences in effective orifice area indexed to body surface area, mean aortic valve gradient, and PPM after TAVR, the degree of LVH regression during intermediate follow-up did not differ between patients receiving supra-annular SE and intra-annular BE prostheses.
Competing Interests: Declaration of competing interest The authors have no competing interests to declare.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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