P423Transcatheter aortic valve implantation is associated with significant regression of left ventricular hypertrophy but not improvement in left ventricular function_ a one year follow-up study


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Abstract

Purpose: Despite the increase in Transcatheter Aortic Valve Implantation (TAVI) procedures over the last few years, little is known about the effect of TAVI on left ventricular (LV) function and remodeling. The aim of this study is to assess the effect of TAVI on echo parameters of LV size, wall thickness, systolic and diastolic function.Methods: We studied 41 patients [age 83 (81-87) year, 18 male] with severe aortic stenosis (AS) before and one year after TAVI procedure using Transthoracic echocardiography. The median LV ejection fraction of the population was 65 (54-70). This retrospective study involved only one patient with poor LV ejection fraction (EF < 45%) and two patients with severe mitral regurgitation (MR) before TAVI. Left ventricular dimensions, left atrial size, LV ejection fraction, LV diastolic function and wall thickness were measured.Results: One year all-cause mortality was 17%. The LV mass decreased from 242±72 g/m2 at baseline to 193±62 g/m2 at one year follow-up (p < 0.05). The diastolic interventricular septum thickness (IVSd) was significantly decreased one year post-TAVI compared with pre-TAVI values (1.29±0.26 vs 1.08±0.20, p <0.001). At one year follow-up the maximum wall thickness (Max WT) decreased from 1.33±0.29 to 1.11±0.17 (p < 0.001). There was no significant change in the left ventricular ejection fraction, LV end systolic diameter, LV end diastolic diameter, left atrial size, fractional shortening and left ventricular diastolic function. There were no significant changes in MR.Conclusion: A significant regression of left ventricular hypertrophy was found one year following TAVI. However, this regression was not associated with changes in LV systolic function, LV diastolic function, LV size or changes in MR.

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