Valvular & structural heart disease
Aortic Valve Calcification and Myocardial Fibrosis Determine Outcome Following Transcatheter Aortic Valve Replacement
Authors' conclusion
MF is associated with adverse CV outcome following TAVR, which is most prevalent in low EF situations. In the presence of large MF burden, patients with large AVC have better outcome following TAVR.
Study context
- Population
- Patients with severe aortic stenosis (AS) and indication for transcatheter aortic valve replacement (TAVR), enrolled January 2017–October 201892 with completed protocol
- Participants
- 100 patients
- Exposure
- AS phenotypes; Aortic valve calcification (AVC) and myocardial fibrosis (MF) burden
- NEFHGn = 39
- Low EF high-gradient (LEFHG)n = 13
- Low EF low-gradient (LEFLG)n = 25
- Paradoxical low-flow, low-gradient (PLFLG)n = 15
- Outcome
- Cardiovascular (CV) mortality after TAVR
- Follow-up
- Within 600 days after TAVR
Methodological detailsconsecutive patients, TTE, multidetector CT and LV endomyocardial biopsies at time of TAVR
- Consecutive patients
- TTE, multidetector CT and LV endomyocardial biopsies at time of TAVR
Main finding
As reported in the abstract
CV mortality
Observational data: associations, not effects.
Further findings
AVC by phenotype
Mortality with higher AVC, in high MF burden (subgroup)
| HR (95% CI) | P value | ||
|---|---|---|---|
| Higher AVCHigh MF burden | 0.261 (0.07–0.97) | P = 0.045 | |
| 0.050.21520Hazard ratio (log scale) |
- AVC by phenotype: high- vs low-gradient P < 0.05
MF prevalence by phenotype
- MF most prevalent in low-output phenotypes (LEFLG > LEFHG > PLFLG > NEFHG)
- P < 0.05
Original publication
Aortic Valve Calcification and Myocardial Fibrosis Determine Outcome Following Transcatheter Aortic Valve Replacement. ESC Heart Fail. Published 14 April 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →