title: Early regression of left ventricular mass associated with diastolic improvement after transcatheter aortic valve implantation.
abstract: BACKGROUND
  The aim of this study was to investigate the effects of transcatheter aortic valve implantation (TAVI) on left ventricular (LV) hypertrophy and diastolic function in patients with severe aortic valve stenosis (AVS). There are few and conflicting data on LV mass remodeling and LV diastolic function after TAVI.
  
  
  METHODS
  Echocardiography and clinical assessment were performed at baseline and at 6 months in high-risk patients affected by severe AVS who underwent TAVI.
  
  
  RESULTS
  One hundred thirty-five patients successfully underwent TAVI. Peak transvalvular aortic pressure gradient and mean transvalvular aortic pressure gradient were reduced from 87 ± 25 to 18 ± 7 mm Hg and from 54 ± 14 to 9 ± 4 mm Hg, respectively (P < .001), accompanied by significant clinical improvement. The mean LV ejection fraction improved from 50 ± 13% to 54 ± 11% during follow-up (P = .009). At 6-month follow-up, interventricular septal wall thickness regressed from 14 ± 2 to 12 ± 1 mm and posterior wall thickness from 13 ± 3 to 11 ± 2 mm (P < .001). LV mass and LV mass index decreased from 332 ± 106 to 228 ± 58 g (P < .001) and from 191 ± 58 to 132 ± 30 g/m(2) (P < .001), respectively. Ninety-seven patients (72%) showed improvements in LV diastolic filling pattern. The mean e' value increased from 4.1 ± 1.7 to 5.6 ± 2.2 cm/sec, and the mean E/e' ratio decreased from 24 ± 7 to 17 ± 6 (P < .001) after TAVI.
  
  
  CONCLUSIONS
  Significant LV mass reverse remodeling associated with improvement in LV systolic and diastolic function was found in patients with severe AVS 6 months after TAVI. These changes may have relevant clinical prognostic value.
authors: Cardiovascular Disease Section, Department of Applied Experimental Medicine, University of Brescia, Italy. enrico.vizzardi@tin.it
authors: Enrico
authors: E
authors: Vizzardi
authors: Antonio
authors: A
authors: D'Aloia
authors: Claudia
authors: C
authors: Fiorina
authors: Silvia
authors: S
authors: Bugatti
authors: Giovanni
authors: G
authors: Parrinello
authors: Marco
authors: M
authors: De Carlo
authors: Cristina
authors: C
authors: Giannini
authors: Vitantonio
authors: V
authors: Di Bello
authors: Anna Sonia
authors: AS
authors: Petronio
authors: Salvatore
authors: S
authors: Curello
authors: Federica
authors: F
authors: Ettori
authors: Livio
authors: L
authors: Dei Cas
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006328:Cardiac Catheterization; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D013318:Stroke Volume; D016896:Treatment Outcome