Author + information
- Polydoros Kampaktsis,
- Amiran Baduashvili,
- Shing–Chiu Wong,
- Fay Lin,
- Richard Devereux,
- Evelyn Horn,
- Dolores Reynolds,
- Tracey Shannon,
- Karl Krieger,
- Arash Salemi,
- Luke Kim,
- Dmitriy Feldman,
- Geoffrey Bergman and
- Robert Minutello
Paravalvular aortic regurgitation (PAR) following transcatheter aortic valve replacement (TAVR) has been identified as a risk factor for long–term mortality. Moreover, even mild PAR following TAVR is associated with a worse prognosis as compared to no or trace PAR. Comparisons of left ventricular (LV) remodeling in patients post–TAVR with mild PAR versus no PAR have not been well analyzed.
We analyzed 48 patients (20 patients with mild PAR, 28 patients with no/trace PAR) following TAVR who underwent an ECHO 30–60 days following valve implantation. Baseline clinical characteristics were compared between the two groups. ECHO parameters including LV mass, LV dimensions and ejection fraction were analyzed and compared to baseline, pre–TAVR measurements, and the percent changes following TAVR were compared between the two groups.
(see table) Baseline, pre–TAVR variables were similar in both groups, with the exception of age and baseline LV mass. Patients with no/trace PAR had a significantly greater reduction in LV mass, LV systolic dimensions and LV diastolic dimensions on follow–up ECHO as compared to patients with mild PAR. No difference in post–TAVR LV systolic function was observed.
Our findings suggest that the physiology of mild PAR is indeed significant and may play a role in the poorer prognosis of these patients and that LV remodeling is influenced by even mild PAR.
|Mild PAR (n=20)||No/trace PAR (n=28)||p value|
|Gender (male %)||55||29||0.17|
|LV mass (gm/m⁁2)||112||125||0.06|
|mean gradient (mmHg)||40||35||0.21|
|LV mass (% change)||2.4||−10.4||0.006|
|LVEF (% change)||7.5||15.4||0.23|
|LVIDs (% change)||0.8||−5.5||0.04|
|LVIDd (% change)||3.7||−1.3||0.05|
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Structural Heart Disease Intervention
Abstract Category: 49. TCT@ACC–i2: Aortic Valve Disease
Presentation Number: 2114–235
- 2013 American College of Cardiology Foundation