A new wearable e monitoring technology for evaluation of left ventricular remodeling after transcatheter aortic valve replacement.

AIMS

Pathological left ventricular (LV) remodelling following aortic stenosis (AS) confers high risk for heart failure and significantly decreases survival. This study aims to introduce a new wearable acoustic cardiography (ACG) device measuring electromechanical activation time (EMAT) to identify the regression of cardiac remodelling in AS patients undergoing transcatheter aortic valve replacement (TAVR).

METHODS AND RESULTS

This prospective cohort study consecutively enrolled patients with severe symptomatic AS who underwent successful TAVR. The parameters EMAT and EMAT% (EMAT divided by R-R interval, expressed as a percentage) derived from ACG as well as echocardiography data were collected. Pearson correlation analysis was performed to evaluate the correlation between EMAT% and left ventricular mass index (LVMi). Receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of EMAT% in predicting left ventricular hypertrophy (LVH). A total of 159 patients (mean age 72.0 years) were enrolled in the study. At baseline, 55% of patients demonstrated severe LV remodelling. Scatter plots and Pearson correlation analysis revealed a significant association between EMAT% and LVMi. The ROC curve analysis showed strong diagnostic performance of EMAT% in predicting LVH, with an area under the curve consistently exceeding 80% at baseline and during follow-up. Both EMAT% and echocardiographic parameters indicated that LV remodelling progressively improved between 1 and 6 months after TAVR, with stabilization observed at 12 months.

CONCLUSION

The EMAT can be considered as an effective tool to assist in the evaluation of LV remodelling after TAVR. Further studies are required to confirm its utility as a valuable non-invasive diagnostic and monitoring tool.