Left ventricular reverse remodeling and reduction of interstitial fibrosis in patients with severe aortic stenosis who underwent transcatheter aortic valve implantation

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine Pub Date : 2025-04-01 DOI:10.1016/j.carrev.2024.06.022

Teruaki Wada , Shingo Ota , Kentaro Honda , Takashi Tanimoto , Akira Taruya , Takahiro Nishi , Jumpei Takeda , Ryo Hikida , Yoshinori Asae , Masahiro Takahata , Yuichi Ozaki , Manabu Kashiwagi , Yasutsugu Shiono , Akio Kuroi , Takashi Yamano , Kazushi Takemoto , Hironori Kitabata , Yoshiharu Nishimura , Atsushi Tanaka

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引用次数: 0

Abstract

Background

Left ventricular (LV) structural and functional changes have been reported in patients with aortic stenosis (AS) who have undergone transcatheter aortic valve implantation (TAVI); however, the relationship between change in LV structure and systolic function and tissue characteristics assessed via cardiovascular magnetic resonance imaging (CMRI) post-TAVI has been not fully elucidated. This study aimed to investigate this relationship in patients with severe AS who underwent TAVI and CMRI.

Methods

In this retrospective study, 65 patients who underwent TAVI and CMRI at the 6-month follow-up were analyzed. The relationship between percent changes in LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LV ejection fraction (LVEF), and LV mass (LVM) (⊿LVEDV, ⊿LVESV, ⊿LVEF, and ⊿LVM) and those in the native T1 value (⊿native T1) was analyzed using a correlation analysis. Moreover, extracellular volume fraction (ECV) value changes were analyzed.

Results

The ⊿native T1 significantly decreased from 1292.8 (1269.9–1318.4) ms at pre-TAVI to 1282.3 (1262.6–1310.2) ms at the 6-month follow-up (P = 0.022). A significant positive correlation between ⊿LVEDV, ⊿LVESV, and ⊿LVM and ⊿native T1 (r = 0.351, P = 0.004; r = 0.339, P = 0.006; r = 0.261, P = 0.035, respectively) and a tendency toward a negative correlation between ⊿LVEF and ⊿native T1 (r = −0.237, P = 0.058) were observed. The ECV value increased significantly from 26.7 % (25.3–28.3) to 28.2 % (25.7–30.5) (P = 0.002).

Conclusions

The decrease in native T1 might be associated with LV reverse remodeling. Evaluating structural and functional changes using CMRI may be useful for patient management.

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接受经导管主动脉瓣植入术的重度主动脉瓣狭窄患者的左心室反向重塑和间质纤维化减少。

背景：接受经导管主动脉瓣植入术（TAVI）的主动脉瓣狭窄（AS）患者的左心室（LV）结构和功能变化已有报道；然而，TAVI术后LV结构和收缩功能的变化与心血管磁共振成像（CMRI）评估的组织特征之间的关系尚未完全阐明。本研究旨在调查接受 TAVI 和 CMRI 的重度 AS 患者的这种关系：在这项回顾性研究中，对 65 名接受 TAVI 和 CMRI 的患者进行了 6 个月的随访分析。采用相关性分析方法分析了左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室射血分数（LVEF）和左心室质量（LVM）（⊿LVEDV、⊿LVESV、⊿LVEF 和⊿LVM）的百分比变化与原生 T1 值（⊿原生 T1）的百分比变化之间的关系。此外，还分析了细胞外体积分数（ECV）值的变化：结果：⊿原生 T1 从 TAVI 术前的 1292.8 (1269.9-1318.4) ms 显著降至 6 个月随访时的 1282.3 (1262.6-1310.2) ms（P = 0.022）。⊿LVEDV、⊿LVESV和⊿LVM与⊿原生T1之间存在明显的正相关性（r = 0.351，P = 0.004；r = 0.339，P = 0.006；r = 0.261，P = 0.035），并观察到⊿LVEF 和⊿native T1 之间呈负相关趋势（r = -0.237，P = 0.058）。ECV值从26.7%（25.3-28.3）明显增加到28.2%（25.7-30.5）（P = 0.002）：结论：原生T1的降低可能与左心室反向重塑有关。使用CMRI评估结构和功能变化可能有助于患者管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Revascularization Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.30

自引率

5.90%

发文量

687

审稿时长

36 days

期刊介绍： Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.