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Left ventricular hypertrophy as a predictor of cardiovascular outcomes after transcatheter aortic valve replacement

AIMS: This study aimed to clarify the relationship between cardiovascular prognosis and left ventricular hypertrophy (LVH) in patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR) and to investigate the relationship between cardiac sympathetic nerve (CSN) f...

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Autores principales: Ito, Nobuyasu, Zen, Kan, Takahara, Motoyoshi, Tani, Ryotaro, Nakamura, Shunsuke, Fujimoto, Tomotaka, Takamatsu, Kazuaki, Yashige, Masaki, Kadoya, Yoshito, Yamano, Michiyo, Yamano, Tetsuhiro, Nakamura, Takeshi, Yaku, Hitoshi, Matoba, Satoaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10053161/
https://www.ncbi.nlm.nih.gov/pubmed/36725669
http://dx.doi.org/10.1002/ehf2.14305
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author Ito, Nobuyasu
Zen, Kan
Takahara, Motoyoshi
Tani, Ryotaro
Nakamura, Shunsuke
Fujimoto, Tomotaka
Takamatsu, Kazuaki
Yashige, Masaki
Kadoya, Yoshito
Yamano, Michiyo
Yamano, Tetsuhiro
Nakamura, Takeshi
Yaku, Hitoshi
Matoba, Satoaki
author_facet Ito, Nobuyasu
Zen, Kan
Takahara, Motoyoshi
Tani, Ryotaro
Nakamura, Shunsuke
Fujimoto, Tomotaka
Takamatsu, Kazuaki
Yashige, Masaki
Kadoya, Yoshito
Yamano, Michiyo
Yamano, Tetsuhiro
Nakamura, Takeshi
Yaku, Hitoshi
Matoba, Satoaki
author_sort Ito, Nobuyasu
collection PubMed
description AIMS: This study aimed to clarify the relationship between cardiovascular prognosis and left ventricular hypertrophy (LVH) in patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR) and to investigate the relationship between cardiac sympathetic nerve (CSN) function and these factors using (123)I‐metaiodobenzylguanidine scintigraphy. METHODS AND RESULTS: In this single‐centre, retrospective observational study, 349 patients who underwent TAVR at our institution between July 2017 and May 2020 were divided into two groups: those with severe LVH pre‐operatively [severe LVH (+) group] and those without LVH pre‐operatively [severe LVH (−) group]. The rates of freedom from cardiovascular events (cardiovascular death and heart failure hospitalization) were compared. The relationship between changes in left ventricular mass index (LVMi) and changes in delay heart–mediastinum ratio (H/M) from before TAVR to 6 months after TAVR was also investigated. The event‐free rate was significantly lower in the severe LVH (+) group (87.1% vs. 96.0%, log‐rank P = 0.021). The severe LVH (+) group exhibited a significantly lower delay H/M value, scored by (123)I‐metaiodobenzylguanidine scintigraphy, than the severe LVH (−) group (2.33 [1.92–2.67] vs. 2.67 [2.17–3.68], respectively, P < 0.001). Moreover, the event‐free rate of post‐operative cardiovascular events was lower among patients with a delay H/M value < 2.50 than that among other patients (87.7% vs. 97.2%, log‐rank P = 0.012). LVMi was significantly higher (115 [99–130] vs. 90 [78–111] g/m(2), P < 0.001) and delay H/M value was significantly lower (2.53 [1.98–2.83] vs. 2.71 [2.25–3.19], P = 0.025) in the severe LVH (+) group than in the severe LVH (−) group at 6 months after TAVR. Patients with improved LVH at 6 months after TAVR also had increased delay H/M (from 2.51 [2.01–2.81] to 2.67 [2.26–3.02], P < 0.001), whereas those without improved LVH had no significant change in delay H/M (from 2.64 [2.23–3.06] to 2.53 [1.97–3.00], P = 0.829). CONCLUSIONS: Severe LVH before TAVR is a prognostic factor for poor post‐operative cardiovascular outcomes. LVH associated with aortic stenosis and CSN function are correlated, suggesting their involvement in LVH prognosis.
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spelling pubmed-100531612023-03-30 Left ventricular hypertrophy as a predictor of cardiovascular outcomes after transcatheter aortic valve replacement Ito, Nobuyasu Zen, Kan Takahara, Motoyoshi Tani, Ryotaro Nakamura, Shunsuke Fujimoto, Tomotaka Takamatsu, Kazuaki Yashige, Masaki Kadoya, Yoshito Yamano, Michiyo Yamano, Tetsuhiro Nakamura, Takeshi Yaku, Hitoshi Matoba, Satoaki ESC Heart Fail Original Articles AIMS: This study aimed to clarify the relationship between cardiovascular prognosis and left ventricular hypertrophy (LVH) in patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR) and to investigate the relationship between cardiac sympathetic nerve (CSN) function and these factors using (123)I‐metaiodobenzylguanidine scintigraphy. METHODS AND RESULTS: In this single‐centre, retrospective observational study, 349 patients who underwent TAVR at our institution between July 2017 and May 2020 were divided into two groups: those with severe LVH pre‐operatively [severe LVH (+) group] and those without LVH pre‐operatively [severe LVH (−) group]. The rates of freedom from cardiovascular events (cardiovascular death and heart failure hospitalization) were compared. The relationship between changes in left ventricular mass index (LVMi) and changes in delay heart–mediastinum ratio (H/M) from before TAVR to 6 months after TAVR was also investigated. The event‐free rate was significantly lower in the severe LVH (+) group (87.1% vs. 96.0%, log‐rank P = 0.021). The severe LVH (+) group exhibited a significantly lower delay H/M value, scored by (123)I‐metaiodobenzylguanidine scintigraphy, than the severe LVH (−) group (2.33 [1.92–2.67] vs. 2.67 [2.17–3.68], respectively, P < 0.001). Moreover, the event‐free rate of post‐operative cardiovascular events was lower among patients with a delay H/M value < 2.50 than that among other patients (87.7% vs. 97.2%, log‐rank P = 0.012). LVMi was significantly higher (115 [99–130] vs. 90 [78–111] g/m(2), P < 0.001) and delay H/M value was significantly lower (2.53 [1.98–2.83] vs. 2.71 [2.25–3.19], P = 0.025) in the severe LVH (+) group than in the severe LVH (−) group at 6 months after TAVR. Patients with improved LVH at 6 months after TAVR also had increased delay H/M (from 2.51 [2.01–2.81] to 2.67 [2.26–3.02], P < 0.001), whereas those without improved LVH had no significant change in delay H/M (from 2.64 [2.23–3.06] to 2.53 [1.97–3.00], P = 0.829). CONCLUSIONS: Severe LVH before TAVR is a prognostic factor for poor post‐operative cardiovascular outcomes. LVH associated with aortic stenosis and CSN function are correlated, suggesting their involvement in LVH prognosis. John Wiley and Sons Inc. 2023-02-01 /pmc/articles/PMC10053161/ /pubmed/36725669 http://dx.doi.org/10.1002/ehf2.14305 Text en © 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Ito, Nobuyasu
Zen, Kan
Takahara, Motoyoshi
Tani, Ryotaro
Nakamura, Shunsuke
Fujimoto, Tomotaka
Takamatsu, Kazuaki
Yashige, Masaki
Kadoya, Yoshito
Yamano, Michiyo
Yamano, Tetsuhiro
Nakamura, Takeshi
Yaku, Hitoshi
Matoba, Satoaki
Left ventricular hypertrophy as a predictor of cardiovascular outcomes after transcatheter aortic valve replacement
title Left ventricular hypertrophy as a predictor of cardiovascular outcomes after transcatheter aortic valve replacement
title_full Left ventricular hypertrophy as a predictor of cardiovascular outcomes after transcatheter aortic valve replacement
title_fullStr Left ventricular hypertrophy as a predictor of cardiovascular outcomes after transcatheter aortic valve replacement
title_full_unstemmed Left ventricular hypertrophy as a predictor of cardiovascular outcomes after transcatheter aortic valve replacement
title_short Left ventricular hypertrophy as a predictor of cardiovascular outcomes after transcatheter aortic valve replacement
title_sort left ventricular hypertrophy as a predictor of cardiovascular outcomes after transcatheter aortic valve replacement
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10053161/
https://www.ncbi.nlm.nih.gov/pubmed/36725669
http://dx.doi.org/10.1002/ehf2.14305
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