Abstract
Our study aimed to compare the difference of LV mass regression and remodeling in regard of conduction disturbances (CD) following transcatheter aortic valve replacement (TAVR). A prospective analysis of 152 consecutive TAVR patients was performed. 53 patients (34.9%) had CD following TAVR, including 30 (19.7%) permanent pacemaker implantation and 23 (15.2%) new left bundle branch block. In 123 patients with 1-year follow-up, significant improvement of LV ejection fraction (LVEF) (baseline vs 12-month: 65.1 ± 13.2 vs 68.7 ± 9.1, P = 0.017) and reduced LV end-systolic volume (LVESV) (39.8 ± 25.8 vs 34.3 ± 17.1, P = 0.011) was found in non-CD group (N = 85), but not in CD group (N = 38). Both groups had significant decrease in LV mass index (baseline vs 12-month: 148.6 ± 36.9 vs. 136.4 ± 34.7 in CD group, p = 0.023; 153.0 ± 50.5 vs. 125.6 ± 35.1 in non-CD group, p < 0.0001). In 46 patients with 3-year follow-up, only non-CD patients (N = 28) had statistically significant decrease in LV mass index (Baseline vs 36-month: 180.8 ± 58.8 vs 129.8 ± 39.1, p = 0.0001). Our study showed the improvement of LV systolic function, reduced LVESV and LV mass regression at 1 year could be observed in patients without CD after TAVR. Sustained LV mass regression within 3-year was found only in patients without CD.
Highlights
Our study aimed to compare the difference of left ventricular (LV) mass regression and remodeling in regard of conduction disturbances (CD) following transcatheter aortic valve replacement (TAVR)
New onset of CD has been associated with a decreased recovery of LV ejection fraction (LVEF) and a less favorable LV remodeling 6 to 12 months after TAVR, but few data exists regarding the impact to LV mass regression and r emodeling[11,12,13,14,15,16,17]
After TAVR, new onset of CD occurred in 53 patients (34.9%) before discharge, including 30 (19.7%) new PM and 23 (15.2%) new left bundle-branch block (LBBB)
Summary
Our study aimed to compare the difference of LV mass regression and remodeling in regard of conduction disturbances (CD) following transcatheter aortic valve replacement (TAVR). The incidence of conduction disturbances requiring permanent pacemaker (PM) implantation, and new-onset left bundle-branch block (LBBB) have not changed significantly, with reports even suggesting an increased risk after the introduction of newer generation transcatheter valves (THV)[4,5,6,7]. Both LBBB and PM implantation were known to be associated with left ventricular (LV) dyssynchrony and ventricular remodeling, and result in impairment of LV function in long term follow-up[8,9,10]. The aim of this study was to compare the difference of LV function, remodeling and mass regression between the patients with and without CD following TAVR
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