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

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

doi:10.1016/j.carrev.2024.06.022

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

Cardiovasc Revasc Med. 2024 Jun 29:S1553-8389(24)00562-1. doi: 10.1016/j.carrev.2024.06.022. Online ahead of print.

Authors

Teruaki Wada¹, Shingo Ota², Kentaro Honda³, Takashi Tanimoto², Akira Taruya², Takahiro Nishi², Jumpei Takeda², Ryo Hikida², Yoshinori Asae², Masahiro Takahata², Yuichi Ozaki², Manabu Kashiwagi², Yasutsugu Shiono², Akio Kuroi², Takashi Yamano², Kazushi Takemoto², Hironori Kitabata², Yoshiharu Nishimura³, Atsushi Tanaka²

Affiliations

¹ Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan. Electronic address: wadat@wakayama-med.ac.jp.
² Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
³ Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan.

PMID: 38965018
DOI: 10.1016/j.carrev.2024.06.022

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.

Keywords: Cardiovascular magnetic resonance imaging; Left ventricular reverse remodeling; Severe aortic stenosis; Transcatheter aortic valve implantation.