title: Myocardial injury following transcatheter aortic valve implantation: insights from delayed-enhancement cardiovascular magnetic resonance.
abstract: OBJECTIVE
  The aim of this study was to evaluate the presence, localisation and extent of myocardial injury as determined by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) imaging in patients undergoing transcatheter aortic valve implantation (TAVI).
  
  
  RESULTS
  A total of 37 patients, who underwent successful TAVI with a balloon-expandable valve (transapical [TA], n=11; non-TA, n=26), were included. Cardiac biomarker (CK-MB and cTnT) levels were determined at baseline and following TAVI. CMR was performed within a week before and within 30 days following TAVI. Some increase in cardiac biomarkers was detected in 97% of the patients as determined by a rise in cTnT, and in 49% of the patients as determined by a rise in CK-MB. Following TAVI, no new myocardial necrosis defects were observed with the non-TA approach. Nonetheless, all patients who underwent TAVI through the TA approach had new focal myocardial necrosis in the apex, with a median myocardial extent and necrotic mass of 5% [2.0-7.0] and 3.5 g [2.3-4.5], respectively.
  
  
  CONCLUSIONS
  Although some increase in cardiac biomarkers of myocardial injury was systematically detected following TAVI, new myocardial necrosis as evaluated by CMR was observed only in patients undergoing the procedure through the TA approach, involving ~5% of the myocardium in the apex.
authors.affiliation: Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
authors.forename: Henrique B
authors.initials: HB
authors.lastname: Ribeiro
authors.forename: Éric
authors.initials: É
authors.lastname: Larose
authors.forename: Maria
authors.initials: M
authors.lastname: de la Paz Ricapito
authors.forename: Florent
authors.initials: F
authors.lastname: Le Ven
authors.forename: Luis
authors.initials: L
authors.lastname: Nombela-Franco
authors.forename: Marina
authors.initials: M
authors.lastname: Urena
authors.forename: Ricardo
authors.initials: R
authors.lastname: Allende
authors.forename: Ignacio
authors.initials: I
authors.lastname: Amat-Santos
authors.forename: Abdellaziz
authors.initials: A
authors.lastname: Dahou
authors.forename: Romain
authors.initials: R
authors.lastname: Capoulade
authors.forename: Marie-Annick
authors.initials: MA
authors.lastname: Clavel
authors.forename: Siamak
authors.initials: S
authors.lastname: Mohammadi
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Paradis
authors.forename: Robert
authors.initials: R
authors.lastname: De Larochellière
authors.forename: Daniel
authors.initials: D
authors.lastname: Doyle
authors.forename: Éric
authors.initials: É
authors.lastname: Dumont
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
authors.forename: Josep
authors.initials: J
authors.lastname: Rodés-Cabau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods; D005260:Female; D006321:Heart; D006335:Heart Injuries / Q000473:pathology*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods; D016896:Treatment Outcome