Impact of transcatheter aortic valve implantation on the left ventricular mass

Abstract

Background: Aortic stenosis (AS) induces pressure overload of the left ventricle (LV) and results in left ventricular hypertrophy. The remodeling of the LV in patients with AS is a com­plex process including structural and functional disturbances. After aortic valve replacement, reverse remodeling of LV begins. The aim of this study was to evaluate the impact of transcatheter aortic valve ımplantation (TAVI) on LV mass (LVM) in early and mid-term follow-ups after the procedure.

Methods and Results: We enrolled consecutive 75 patients who underwent successful TAVI. Transthoracic echocardiography was performed prior to TAVI and at hospital discharge, in the 1^st month and 6^th month of the follow-ups. The mean LV ejection fraction improved significantly after TAVI (54.2 ± 15.0% to 57.3 ± 11.7%, p < 0.001). There were no significant changes between the baseline and discharge mean LVM and LVM index values (LVMI; p = 0.1). However, LVMI decreased significantly in the 1st month of follow-up compared to baseline (123.3 ± 20.3 to 127.9 ± 21.3 g/m², respectively, p < 0.001). Also, significant regression of LVM was observed at the 1^st month of follow-up compared to baseline (228.3 ± 33.5 g vs. 236.5 ± 34.2 g, respectively, p < 0.001). Furthermore, the significant regression in both of LVM and LVMI continued at 1^st and 6^th months of the follow-ups (p < 0.001).

Conclusions: A significant regression of LVM was observed after TAVI. These changes may have prognostic value in patients with severe AS.