Liu Ran, Li Qiang, Li Yang, Fu Zhaolin, Xie Meng, Yan Xiaowei, Lu Zhinan, Song Guangyuan
Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.
Interventional Ultrasound Department, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China.
Eur Heart J Digit Health. 2025 May 20;6(4):713-722. doi: 10.1093/ehjdh/ztaf050. eCollection 2025 Jul.
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).
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.
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.
主动脉瓣狭窄（AS）后病理性左心室（LV）重构会增加心力衰竭风险并显著降低生存率。本研究旨在引入一种新的可穿戴式心音图（ACG）设备，该设备可测量机电激活时间（EMAT），以识别接受经导管主动脉瓣置换术（TAVR）的AS患者心脏重构的逆转情况。
这项前瞻性队列研究连续纳入了成功接受TAVR的重度症状性AS患者。收集了源自ACG的EMAT和EMAT%（EMAT除以R-R间期，以百分比表示）参数以及超声心动图数据。进行Pearson相关性分析以评估EMAT%与左心室质量指数（LVMi）之间的相关性。采用受试者工作特征（ROC）曲线评估EMAT%在预测左心室肥厚（LVH）方面的诊断性能。共有159名患者（平均年龄72.0岁）纳入本研究。基线时，55%的患者表现出严重的左心室重构。散点图和Pearson相关性分析显示EMAT%与LVMi之间存在显著关联。ROC曲线分析表明，EMAT%在预测LVH方面具有较强的诊断性能，基线和随访期间曲线下面积始终超过80%。EMAT%和超声心动图参数均表明，TAVR后1至6个月期间左心室重构逐渐改善，12个月时观察到稳定状态。
EMAT可被视为辅助评估TAVR后左心室重构的有效工具。需要进一步研究以证实其作为有价值的非侵入性诊断和监测工具的效用。
