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Open Access 01-05-2021 | Aortic Valve Replacement | Original Paper

Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement

Authors: Jakob Ledwoch, Carolin Fröhlich, Ida Olbrich, Felix Poch, Ruth Thalmann, Carmen Fellner, Christian Bradaric, Karl-Ludwig Laugwitz, Christian Kupatt, Petra Hoppmann

Published in: Clinical Research in Cardiology | Issue 5/2021

Abstract

Aims

Atrial fibrillation (AF) is associated with increased mortality after transcatheter aortic valve replacement (TAVR). Cerebrovascular complications and bleeding events associated with anticoagulation therapy are discussed to be possible causes for this increased mortality. The present study sought to assess whether AF is associated with impaired left ventricular (LV) reverse remodeling representing another possible mechanism for poor outcome.

Methods

All patients who underwent TAVR in our institution and had 1-year echocardiography follow-up were included. LV mass index (LVMI) at baseline and follow-up as well as LVMI change at 1 year were assessed with respect to the presence of AF (either at baseline or during hospitalization after TAVR) and sinus rhythm (SR).

Results

A total of 213 patients (n = 95 in AF; n = 118 in SR) were enrolled in the present study. Patients with AF had higher LVMI at 1 year compared to those with SR (173 ± 61 g/m² vs. 154 ± 55 g/m²; p = 0.02) and they showed lower relative LVMI change at 1 year (− 2 ± 28% vs. − 9 ± 29%; p = 0.04). In linear regression analysis, AF was independently associated with relative LVMI change (regression coefficient ß 0.076 [95% CI 0.001–0.150]; p = 0.04). With respect to clinical outcome depending on AF and LVMI regression, the Kaplan–Meier estimated event-free of death or cardiac rehospitalization at 3 years was lowest among patients with AF and no LVMI regression.

Conclusions

The present study identified a significant association of AF with changes in LVMI after TAVR, which was also shown to be associated with clinical outcome.

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Title: Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement
Authors: Jakob Ledwoch
Carolin Fröhlich
Ida Olbrich
Felix Poch
Ruth Thalmann
Carmen Fellner
Christian Bradaric
Karl-Ludwig Laugwitz
Christian Kupatt
Petra Hoppmann
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Keywords: Aortic Valve Replacement
Atrial Fibrillation
Aortic Valve Replacement
Aortic Valve Replacement
Published in: Clinical Research in Cardiology / Issue 5/2021
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-021-01810-5

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Impact of sinus rhythm versus atrial fibrillation on left ventricular remodeling after transcatheter aortic valve replacement

Abstract

Aims

Methods

Results

Conclusions

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