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The International Journal of Cardiovascular Imaging

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08-02-2022 | Aortic Valve Replacement | Original Paper

Left atrial volume index predicts future improvement of B-type natriuretic peptide levels after transcatheter aortic valve replacement

Authors: Asahiro Ito, Yasuhiro Izumiya, Shinichi Iwata, Mana Ogawa, Andrew T. Kim, Ryosuke Yahiro, Yusuke Kure, Tomohiro Yamaguchi, Tsukasa Okai, Yosuke Takahashi, Toshihiko Shibata, Minoru Yoshiyama

Published in: The International Journal of Cardiovascular Imaging | Issue 7/2022

Abstract

In patients with symptomatic severe aortic stenosis (AS), those who experienced readmission due to heart failure after transcatheter aortic valve replacement (TAVR) showed poor prognosis. Furthermore, poor B-type natriuretic peptide (BNP) improvement is associated with increased morbidity and mortality. However, little is known about the clinical parameters related to the change in BNP levels after TAVR procedure. This study population consisted of 127 consecutive patients of symptomatic severe AS with preserved ejection fraction (EF) who underwent transfemoral TAVR (TF-TAVR). Comprehensive transthoracic echocardiography was performed prior to the day of TF-TAVR. BNP was measured serially before and 1 year after TF-TAVR. The median BNP level was significantly decreased from 252.5 pg/ml to 146.8 pg/ml in all 127 patients 1 year after TF-TAVR (P < 0.01). However, the patients could be divided into 2 groups according to decrease (72%) or increase (28%) in plasma BNP level. Multivariate logistic regression analysis revealed that Aortic valve (AV) peak velocity, pre-procedural BNP, and larger left atrial volume index (LAVI) were found to be an independent predictor of increased BNP level 1 year after TAVR (OR 0.55, 95% CI 0.38–0.77; P < 0.01). LAVI were negatively correlated with the change in BNP level before and 1 year after TAVR (r = 0.47, P < 0.01). The ROC analysis demonstrated that 52.9 ml/m² was the optimal cut-off value of LAVI for decreasing BNP 1 year after TAVR (area under the curve 0.69) with 64% sensitivity and 70% specificity. In addition to AV peak velocity and pre-procedural BNP, LAVI independently predicts future improvement of BNP levels 1 year after TAVR. Our findings indicate an additive predictive value of assessment of LAVI before TAVR procedure for risk stratification.

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Title: Left atrial volume index predicts future improvement of B-type natriuretic peptide levels after transcatheter aortic valve replacement
Authors: Asahiro Ito
Yasuhiro Izumiya
Shinichi Iwata
Mana Ogawa
Andrew T. Kim
Ryosuke Yahiro
Yusuke Kure
Tomohiro Yamaguchi
Tsukasa Okai
Yosuke Takahashi
Toshihiko Shibata
Minoru Yoshiyama
Publication date: 08-02-2022
Publisher: Springer Netherlands
Keywords: Aortic Valve Replacement
Transthoracic Echocardiography
Aortic Valve Replacement
Aortic Valve Replacement
Published in: The International Journal of Cardiovascular Imaging / Issue 7/2022
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-022-02538-7

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Left atrial volume index predicts future improvement of B-type natriuretic peptide levels after transcatheter aortic valve replacement

Abstract

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Abstract

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