Regression of Left Ventricular Mass After Transcatheter Aortic Valve Replacement: The PARTNER Trials and Registries.


Journal

Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365

Informations de publication

Date de publication:
19 05 2020
Historique:
received: 21 02 2020
accepted: 15 03 2020
entrez: 16 5 2020
pubmed: 16 5 2020
medline: 1 1 2021
Statut: ppublish

Résumé

Greater early left ventricular mass index (LVMi) regression is associated with fewer hospitalizations 1 year after transcatheter aortic valve replacement (TAVR). The association between LVMi regression and longer-term post-TAVR outcomes is unclear. The purpose of this study was to determine the association between LVMi regression at 1-year post-TAVR and clinical outcomes between 1 and 5 years. Among intermediate- and high-risk patients who received TAVR in the PARTNER (Placement of Aortic Transcatheter Valves) I, II, and S3 trials or registries and were alive at 1 year, we included patients with baseline moderate or severe left ventricular hypertrophy (LVH) and paired measurements of LVMi at baseline and 1 year. The associations between LVMi regression (percent change between baseline and 1 year) and death or rehospitalization from 1 to 5 years were examined. Among 1,434 patients, LVMi was 146 g/m Among patients with moderate or severe LVH treated with TAVR who are alive at 1 year, greater LVMi regression at 1 year is associated with lower death and hospitalization rates to 5 years. These findings may have implications for the timing of valve replacement and the role of adjunctive medical therapy after TAVR.

Sections du résumé

BACKGROUND
Greater early left ventricular mass index (LVMi) regression is associated with fewer hospitalizations 1 year after transcatheter aortic valve replacement (TAVR). The association between LVMi regression and longer-term post-TAVR outcomes is unclear.
OBJECTIVES
The purpose of this study was to determine the association between LVMi regression at 1-year post-TAVR and clinical outcomes between 1 and 5 years.
METHODS
Among intermediate- and high-risk patients who received TAVR in the PARTNER (Placement of Aortic Transcatheter Valves) I, II, and S3 trials or registries and were alive at 1 year, we included patients with baseline moderate or severe left ventricular hypertrophy (LVH) and paired measurements of LVMi at baseline and 1 year. The associations between LVMi regression (percent change between baseline and 1 year) and death or rehospitalization from 1 to 5 years were examined.
RESULTS
Among 1,434 patients, LVMi was 146 g/m
CONCLUSIONS
Among patients with moderate or severe LVH treated with TAVR who are alive at 1 year, greater LVMi regression at 1 year is associated with lower death and hospitalization rates to 5 years. These findings may have implications for the timing of valve replacement and the role of adjunctive medical therapy after TAVR.

Identifiants

pubmed: 32408979
pii: S0735-1097(20)34675-1
doi: 10.1016/j.jacc.2020.03.042
pii:
doi:

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

2446-2458

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Auteurs

Katherine H Chau (KH)

Cardiovascular Research Foundation, New York, New York; Structural Heart and Valve Center, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, New York.

Pamela S Douglas (PS)

Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.

Philippe Pibarot (P)

Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada.

Rebecca T Hahn (RT)

Structural Heart and Valve Center, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, New York.

Omar K Khalique (OK)

Structural Heart and Valve Center, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, New York.

Wael A Jaber (WA)

Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.

Paul Cremer (P)

Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.

Neil J Weissman (NJ)

Medstar Health Research Institute, Georgetown University, Washington, DC.

Federico M Asch (FM)

Medstar Health Research Institute, Georgetown University, Washington, DC.

Yiran Zhang (Y)

Cardiovascular Research Foundation, New York, New York.

Zachary M Gertz (ZM)

Virginia Commonwealth University School of Medicine, Richmond, Virginia.

Sammy Elmariah (S)

Massachusetts General Hospital, Boston, Massachusetts.

Marie-Annick Clavel (MA)

Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada.

Vinod H Thourani (VH)

Department of Cardiovascular Surgery, Marcus Heart and Vascular Center, Piedmont Heart Institute, Atlanta, Georgia.

Melissa Daubert (M)

Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.

Maria C Alu (MC)

Cardiovascular Research Foundation, New York, New York; Structural Heart and Valve Center, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, New York.

Martin B Leon (MB)

Cardiovascular Research Foundation, New York, New York; Structural Heart and Valve Center, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, New York.

Brian R Lindman (BR)

Structural Heart and Valve Center, Vanderbilt University Medical Center, Nashville, Tennessee; Cardiovascular Medicine Division, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: brian.r.lindman@vumc.org.

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