This study looked at patients with moderate to severe left ventricular hypertrophy and aortic stenosis treated with transcatheter aortic valve replacement (TAVR). Patients with reduced hypertrophy had lower mortality and fewer hospitalizations at 5 years.
It included all moderate to severe risk patients with ventricular hypertrophy undergoing TAVR in the studies and registries PARTNER (I, II and S3) who had survived one year after procedure.
The study looked at the link between ventricular mass index regression (percent change between baseline and 1 year) and mortality or rehospitalization at one and five years.
In 1434 patients with mean ventricular mass index 146 g/m2 at baseline (range 133 to 168 g/m2 ) there was 14.5% regression to mean 126 g/m2 at one year.
After adjusting for multiple variables, it was found the greater the left ventricular mass index at one year, the lower the mortality rate (HR: 0.95 per 10% regression, p=0.004).
Severe hypertrophy, observed in 39% of patients, was an independent factor of all-cause mortality, with similar association to cardiovascular mortality and rehospitalization. This is why left ventricular mass index regression had an impact on these points.
Conclusion
Ventricular hypertrophy regression one year after TAVR is associated with reduced mortality and rehospitalization at 5 years. These findings may impact the optimal time for TAVR as well as medical treatment after TAVR.
Original Title: Regression of Left Ventricular Mass After Transcatheter Aortic Valve Replacement The PARTNER Trials and Registries.
Reference: Katherine H. Chau et al. J Am Coll Cardiol 2020;75:2446–58.
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