Yamaguchi Satoshi, Otaki Yuka, Tamarappoo Balaji K, Ohira Tetsuya, Ikenaga Hiroki, Yoshida Jun, Chakravarty Tarun, Friedman John, Berman Daniel, Rader Florian, Siegel Robert J, Makkar Raj, Shiota Takahiro
Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Department of Epidemiology, Fukushima Medical University, Fukushima 960-1247, Japan.
J Clin Med. 2020 Sep 29;9(10):3143. doi: 10.3390/jcm9103143.
Increase in left ventricular (LV) mass develops as a compensatory mechanism against pressure overload in aortic valve stenosis. However, long-standing LV geometrical changes are related to poor prognosis. The LV geometrical change occurs after transcatheter aortic valve replacement (TAVR). The present study aimed to investigate the relationship between improvement in valvuloarterial impedance (Zva) and change in LV mass index (LVMI) and the ratio of LVMI to LV end-diastolic volume index (LVMI/LVEDVI). We compared these relationships to that between Zva and mean pressure gradient (MPG). Baseline and follow-up transthoracic echocardiograms of 301 patients who underwent TAVR from November 2011 to December 2015 were reviewed. Spearman correlation coefficient (ρ) was used to compare ΔLVMI and ΔLVMI/LVEDVI with Zva or MPG. The correlation between ΔZva and ΔLVMI (ρ = 0.47, < 0.001) was superior to that between ΔMPG and ΔLVMI (ρ = 0.15, = 0.009) ( for comparison < 0.001). The correlation between ΔZva and ΔLVMI/LVEDVI was statistically significant (ρ = 0.54, < 0.001); in contrast, that of ΔMPG and ΔLVMI/LVEDVI was not. The improvement in Zva after TAVR was more closely related to LVMI and LVMI/LVEDVI reduction than MPG reduction.
左心室（LV）质量增加是作为主动脉瓣狭窄时压力超负荷的一种代偿机制而出现的。然而，长期存在的左心室几何形状改变与不良预后相关。左心室几何形状改变发生在经导管主动脉瓣置换术（TAVR）之后。本研究旨在探讨瓣膜动脉阻抗（Zva）改善与左心室质量指数（LVMI）变化以及LVMI与左心室舒张末期容积指数之比（LVMI/LVEDVI）之间的关系。我们将这些关系与Zva和平均压力梯度（MPG）之间的关系进行了比较。回顾了2011年11月至2015年12月期间接受TAVR的301例患者的基线和随访经胸超声心动图。采用Spearman相关系数（ρ）来比较ΔLVMI和ΔLVMI/LVEDVI与Zva或MPG的关系。ΔZva与ΔLVMI之间的相关性（ρ = 0.47，<0.001）优于ΔMPG与ΔLVMI之间的相关性（ρ = 0.15，= 0.009）（比较时<0.001）。ΔZva与ΔLVMI/LVEDVI之间的相关性具有统计学意义（ρ = 0.54，<0.001）；相比之下，ΔMPG与ΔLVMI/LVEDVI之间的相关性则无统计学意义。TAVR后Zva的改善与LVMI及LVMI/LVEDVI降低的关系比MPG降低更为密切。
