Valvular & structural heart diseaseCohort study
Comparison of Pressure vs Volume Overload Ventricular Wall Stress in Patients With Valvular Heart Disease
- Prospective cohort study
- invasive haemodynamics combined with CMR
Authors' conclusion
TAVR results in significant reductions in systolic LVWS acutely. MC results in significant reductions in diastolic LVWS. Higher baseline systolic LVWS in TAVR is associated with shorter 6MWT suggesting that in AS, LVWS may be a useful marker of early decompensation.
Study context
- Population
- Patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) or severe mitral regurgitation (MR) undergoing MitraClip
- Participants
- 47 vs 15
- Exposure
- LV wall stress before vs after TAVR and MitraClip
- TAVRn = 47
- MitraClip (MC)n = 15
Main finding
As reported in the abstract
TAVR: systolic left ventricular wall stress (LVWS) median 24.7 Pa (IQR 14 Pa) pre vs 17.3 Pa (IQR 12 Pa) post
P < 0.001
MC: diastolic LVWS median 6.4 Pa (IQR 5 Pa) pre vs 4.3 Pa (IQR 4.1 Pa) post
P = 0.021
MC: systolic LVWS 30.6 ±1.61 pre vs 33 ±2.47 Pa post, no significant change
P = 0.16
Observational data: associations, not effects.
Further findings
Baseline systolic LVWS vs 6MWT (TAVR)
- Inverse correlation, r = −0.31
- P = 0.04
Original publication
Summarised from the published abstract; every number is checked against it