Zakkar Mustafa, Alassar Aiman, Lopez-Perez Manuel, Roy David, Brecker Stephen, Sharma Rajan, Jahangiri Marjan
From the Department of Cardiothoracic Surgery, St George's Hospital, London, UK.
Innovations (Phila). 2015 Jan-Feb;10(1):44-7. doi: 10.1097/IMI.0000000000000122.
The impact of transcatheter aortic valve implantation (TAVI) on left ventricular (LV) mass regression is not well defined. We aimed to measure LV mass regression, changes in LV volumes and dimensions, as well as mitral valve function after TAVI.
Eighty patients who underwent TAVI between 2008 and 2010 were studied. Echocardiographic findings before procedure and at 6- and 12-month follow-up were analyzed.
Aortic valve area increased from 0.71 (0.27) cm before procedure to 1.89 (0.64) cm at 12 months (P < 0.001), which was associated with reduction in peak [80.79 (23) vs 16.9 (6.5) mm Hg, P < 0.001] and mean [47.65 (14.2) vs 8.77 (3.29) mm Hg, P < 0.001] gradients. At 1 year, there was a change in LV end-systolic volume [46.12 (36.6) to 48.96 (4.05) mL, P = 0.042] and LV mass [202.4 (92.2) to 183.6 (98.2) g, P = 0.04]. Left ventricular mass index regressed from 130.7 (28.9) to 122.1 (28.9) g/m (P = 0.01). Maximum wall thickness decreased from 1.28 (0.18) to 1.25 (0.17) cm (P < 0.001). There was no significant change in LV ejection fraction, LV end-systolic and end-diastolic diameters, as well as mitral valve regurgitation.
Transcatheter aortic valve implantation is associated with significant regression of LV hypertrophy at 1 year. However, this regression was not associated with changes in LV systolic and diastolic functions, size, or changes in mitral valve regurgitation.
经导管主动脉瓣植入术（TAVI）对左心室（LV）质量消退的影响尚不明确。我们旨在测量TAVI术后左心室质量消退、左心室容积和尺寸的变化以及二尖瓣功能。
对2008年至2010年间接受TAVI的80例患者进行研究。分析术前及术后6个月和12个月的超声心动图检查结果。
主动脉瓣面积从术前的0.71（0.27）cm²增加到12个月时的1.89（0.64）cm²（P<0.001），这与峰值压差[80.79（23）对16.9（6.5）mmHg，P<0.001]和平均压差[47.65（14.2）对8.77（3.29）mmHg，P<0.001]的降低相关。1年时，左心室收缩末期容积[46.12（36.6）至48.96（4.05）mL，P=0.042]和左心室质量[202.4（92.2）至183.6（98.2）g，P=0.04]发生变化。左心室质量指数从130.7（28.9）降至122.1（28.9）g/m²（P=0.01）。最大壁厚从1.28（0.18）cm降至1.25（0.17）cm（P<0.001）。左心室射血分数、左心室收缩末期和舒张末期直径以及二尖瓣反流均无显著变化。
经导管主动脉瓣植入术在1年时与左心室肥厚的显著消退相关。然而，这种消退与左心室收缩和舒张功能、大小的变化或二尖瓣反流的变化无关。
