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Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement
AIMS: Atrial fibrillation (AF) is associated with increased mortality after transcatheter aortic valve replacement (TAVR). Cerebrovascular complications and bleeding events associated with anticoagulation therapy are discussed to be possible causes for this increased mortality. The present study sou...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099831/ https://www.ncbi.nlm.nih.gov/pubmed/33566184 http://dx.doi.org/10.1007/s00392-021-01810-5 |
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author | Ledwoch, Jakob Fröhlich, Carolin Olbrich, Ida Poch, Felix Thalmann, Ruth Fellner, Carmen Bradaric, Christian Laugwitz, Karl-Ludwig Kupatt, Christian Hoppmann, Petra |
author_facet | Ledwoch, Jakob Fröhlich, Carolin Olbrich, Ida Poch, Felix Thalmann, Ruth Fellner, Carmen Bradaric, Christian Laugwitz, Karl-Ludwig Kupatt, Christian Hoppmann, Petra |
author_sort | Ledwoch, Jakob |
collection | PubMed |
description | AIMS: Atrial fibrillation (AF) is associated with increased mortality after transcatheter aortic valve replacement (TAVR). Cerebrovascular complications and bleeding events associated with anticoagulation therapy are discussed to be possible causes for this increased mortality. The present study sought to assess whether AF is associated with impaired left ventricular (LV) reverse remodeling representing another possible mechanism for poor outcome. METHODS: All patients who underwent TAVR in our institution and had 1-year echocardiography follow-up were included. LV mass index (LVMI) at baseline and follow-up as well as LVMI change at 1 year were assessed with respect to the presence of AF (either at baseline or during hospitalization after TAVR) and sinus rhythm (SR). RESULTS: A total of 213 patients (n = 95 in AF; n = 118 in SR) were enrolled in the present study. Patients with AF had higher LVMI at 1 year compared to those with SR (173 ± 61 g/m(2) vs. 154 ± 55 g/m(2); p = 0.02) and they showed lower relative LVMI change at 1 year (− 2 ± 28% vs. − 9 ± 29%; p = 0.04). In linear regression analysis, AF was independently associated with relative LVMI change (regression coefficient ß 0.076 [95% CI 0.001–0.150]; p = 0.04). With respect to clinical outcome depending on AF and LVMI regression, the Kaplan–Meier estimated event-free of death or cardiac rehospitalization at 3 years was lowest among patients with AF and no LVMI regression. CONCLUSIONS: The present study identified a significant association of AF with changes in LVMI after TAVR, which was also shown to be associated with clinical outcome. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00392-021-01810-5. |
format | Online Article Text |
id | pubmed-8099831 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-80998312021-05-11 Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement Ledwoch, Jakob Fröhlich, Carolin Olbrich, Ida Poch, Felix Thalmann, Ruth Fellner, Carmen Bradaric, Christian Laugwitz, Karl-Ludwig Kupatt, Christian Hoppmann, Petra Clin Res Cardiol Original Paper AIMS: Atrial fibrillation (AF) is associated with increased mortality after transcatheter aortic valve replacement (TAVR). Cerebrovascular complications and bleeding events associated with anticoagulation therapy are discussed to be possible causes for this increased mortality. The present study sought to assess whether AF is associated with impaired left ventricular (LV) reverse remodeling representing another possible mechanism for poor outcome. METHODS: All patients who underwent TAVR in our institution and had 1-year echocardiography follow-up were included. LV mass index (LVMI) at baseline and follow-up as well as LVMI change at 1 year were assessed with respect to the presence of AF (either at baseline or during hospitalization after TAVR) and sinus rhythm (SR). RESULTS: A total of 213 patients (n = 95 in AF; n = 118 in SR) were enrolled in the present study. Patients with AF had higher LVMI at 1 year compared to those with SR (173 ± 61 g/m(2) vs. 154 ± 55 g/m(2); p = 0.02) and they showed lower relative LVMI change at 1 year (− 2 ± 28% vs. − 9 ± 29%; p = 0.04). In linear regression analysis, AF was independently associated with relative LVMI change (regression coefficient ß 0.076 [95% CI 0.001–0.150]; p = 0.04). With respect to clinical outcome depending on AF and LVMI regression, the Kaplan–Meier estimated event-free of death or cardiac rehospitalization at 3 years was lowest among patients with AF and no LVMI regression. CONCLUSIONS: The present study identified a significant association of AF with changes in LVMI after TAVR, which was also shown to be associated with clinical outcome. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00392-021-01810-5. Springer Berlin Heidelberg 2021-02-10 2021 /pmc/articles/PMC8099831/ /pubmed/33566184 http://dx.doi.org/10.1007/s00392-021-01810-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Paper Ledwoch, Jakob Fröhlich, Carolin Olbrich, Ida Poch, Felix Thalmann, Ruth Fellner, Carmen Bradaric, Christian Laugwitz, Karl-Ludwig Kupatt, Christian Hoppmann, Petra Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement |
title | Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement |
title_full | Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement |
title_fullStr | Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement |
title_full_unstemmed | Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement |
title_short | Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement |
title_sort | impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099831/ https://www.ncbi.nlm.nih.gov/pubmed/33566184 http://dx.doi.org/10.1007/s00392-021-01810-5 |
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