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Left Ventricular Reverse Remodeling After TAVR for Aortic Stenosis
Session:
Posters (Sessão 2 - Écran 8) - Doença Valvular 2 - Foco no Ecocardiograma na Válvula Aórtica
Speaker:
Fábio Sousa Nunes
Congress:
CPC 2022
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.7 Valvular Heart Disease - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Fábio Sousa Nunes; Rafael Teixeira; Pedro Gonçalves Teixeira; Pedro Ribeiro Queirós; Mariana Ribeiro Silva; Gualter Santos Silva; Diogo Santos Ferreira; Mariana Brandão; Cláudio Espada Guerreiro; Gustavo Pires de Morais; Bruno Melica; Lino Santos; Alberto Rodrigues; Pedro Braga; Ricardo Fontes Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Introduction: The extent of Left Ventricular (LV) reverse remodeling after transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) reflects the unloading of the LV after the outflow tract obstruction has been resolved. We aim to assess the extent of LV reverse remodeling after TAVR for severe AS, particularly the time needed for such reverse remodeling to fully develop.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods: We selected 134 patients who underwent TAVR at our institution for severe AS between 2007 and 2020 and had preprocedural and postprocedural echocardiograms performed at our institution. Mean values of echocardiographic parameters were predicted based on the LOESS regression. Demographic and clinical data were collected from the electronic health records. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results: Patients had a mean age of 80±7 years and 55% were male. More than 69% of patients presented with NYHA IV at the procedure. Data regarding echocardiographic variables of interest are presented as mean (95% confidence interval) and are reproduced in the accompanying graphic. Mean Aortic Gradient (mmHg): preprocedural 47.7 (45.7-49.7), at 6 months after TAVR: 10.14 (9.3-10.9) and at 12 months after TAVR: 10.9 (9.9-11.9). Aortic Valve Area (cm2): preprocedural: 0.70 (0.67-0.73), 6 months: 1.67 (1.47-1.87), 12 months: 1.82 (1.62-2.02). LV mass (g): preprocedural 257.1 (248.1-266.2), 6 months (230.8-221.1), 12 months 228.5 (216.4-240.6). LV ejection fraction (%): preprocedural 52.6 (50.9-54.3), 6 months: 53.4 (51.5-55.2), 12 months 53.3 (51.1-55.6). LV end-diastolic diameter (cm): preprocedural 5.0 (4.9-5.1), 6 months 4.9 (4.8-5.1), 12 months 5.0 (4.9-5.2). LV end-diastolic volume (mL): preprocedural 112.1 (105.9-118.2), 6 months 109.2 (101.6-116.8) and 12 months 109.9 (100.4-119.3). The chief LV alteration after TAVR was on LV mass with the greatest change at the first evaluation and little change thereafter.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusions: This work presents data on the reverse LV remodeling after TAVR for AS. In our sample, reverse remodeling occurred precociously and changed little thereafter. </span></span></p>
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