P778Left atrium remodeling improvement after transcatheter aortic valve implantation


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Abstract

Introduction: Severe aortic stenosis (AS) is associated with left atrium (LA) dilatation and left ventricle (LV) hypertrophy, which are related to adverse clinical outcomes. Up to now, results on the effects of the transcatheter aortic valve implantation (TAVI) in LV mass and left atrium remodelling are scarce. This study aimed to assess the effect of TAVI in left cardiac chambers at midterm follow-up.Methods: From April 2009 to April 2010, consecutive patients with severe symptomatic aortic valve stenosis and the indication for TAVI were included. Examinations of study patients were performed before, and 6.5 (3.5 to 9.8 interquartile range) months after TAVI, using transthoracic 3D echocardiography. LV mass was calculated by 3D guided biplane analysis, LV and LA volumes were calculated by direct volumetric analysis.Results: 53 patients completed the follow-up. After the procedure there were significant reductions in peak (84.2±21.5 mmHg to 15.3±6.5 mmHg; p < 0.001) and mean (49.1 ± 13.0 mmHg to 7.4 ± 3.5 mmHg; p < 0.001) transvalvular gradients and increases in calculated aortic valve areas (0.6 ±0.1 cm2 to 1.7± 0.6cm2). At follow-up LA volume significantly decreased (79.5 ±22.4 mL to 71.1±23.3 mL; p=0.048) and no significant difference in LV systolic function (57.8±13.2% to 61.0 ±11.2) or LV mass (130.2±39.1 g/m2 to 127.7±40.1g/m2; p=0.754) was found.Conclusion: LA volume significantly reduces at midterm after TAVI. This result corroborates with the expectations of LV diastolic function improvement and might predict a favourable clinical outcome.

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