Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses

Anh Ngo; Christian Hassager; Hans Gustav Hørsted Thyregod; Lars Søndergaard; Peter Skov Olsen; Daniel Steinbrüchel; Peter Bo Hansen; Jesper Kjærgaard; Mathilde Winther-Jensen; Nikolaj Ihlemann

doi:10.1093/ehjci/jew321

Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses

Anh Ngo^*, Christian Hassager, Hans Gustav Hørsted Thyregod, Lars Søndergaard, Peter Skov Olsen, Daniel Steinbrüchel, Peter Bo Hansen, Jesper Kjærgaard, Mathilde Winther-Jensen, Nikolaj Ihlemann

^*Corresponding author for this work

Department of Clinical Medicine

12 Citations (Scopus)

Abstract

Aims Patients with severe aortic stenosis (AS) can be considered for treatment with either transcatheter (TAVR) or surgical aortic valve replacement (SAVR). The purpose of this study was to compare left ventricular (LV) remodeling in patients with AS after treatment with TAVR or SAVR. Methods and results This is an echocardiographic substudy of the NOTION trial, a randomized all-comers trial comparing TAVR with SAVR in patients above 70 years of age. Transthoracic echocardiograms were performed at baseline, 3 and 12 months after TAVR and SAVR. About 232 patients were included in the study, 120 were randomized to TAVR and 112 to SAVR. From baseline to 12 months post-procedure, aortic valve area (AVA) increased in both groups, but with a larger increase in the TAVR group (0.65 ± 0.04 cm 2 vs. 1.02 ± 0.05 cm 2 for SAVR and TAVR group, P < 0.0001). At 12 months, LV mass regression was more pronounced in the SAVR group as compared with TAVR (17.5% vs. 7.2%, P < 0.001). In the TAVR group at 12 months, end diastolic volume (EDV) increased by 10.2 ± 2.5 ml and, in the SAVR group, EDV decreased by 15.4 ± 2.6 ml with a statistically significant difference between the two groups (P < 0.0001). Paravalvular leakage (PVL) and pacemaker implantations were more common in patients treated with TAVR, which was associated with an increase in EDV (P < 0.01). Conclusion Patients undergoing SAVR had a larger LV mass regression at 1 year compared with patients undergoing TAVR, which may be due to increasing amounts of PVL and pacemakers in the TAVR group. Published on behalf of the European Society of Cardiology. All rights reserved.

Original language	English
Journal	European Heart Journal Cardiovascular Imaging
Volume	19
Issue number	1
Pages (from-to)	39-46
Number of pages	8
ISSN	2047-2404
DOIs	https://doi.org/10.1093/ehjci/jew321
Publication status	Published - 2018

Keywords

aortic stenosis
aortic valve replacement
left ventricular remodelling and paravalvular regurgitation
transcatheter aortic valve implantation

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Ngo, A., Hassager, C., Thyregod, H. G. H., Søndergaard, L., Olsen, P. S., Steinbrüchel, D., Hansen, P. B., Kjærgaard, J., Winther-Jensen, M., & Ihlemann, N. (2018). Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses. European Heart Journal Cardiovascular Imaging, 19(1), 39-46. https://doi.org/10.1093/ehjci/jew321

Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses. / Ngo, Anh; Hassager, Christian; Thyregod, Hans Gustav Hørsted et al.
In: European Heart Journal Cardiovascular Imaging, Vol. 19, No. 1, 2018, p. 39-46.

Research output: Contribution to journal › Journal article › Research › peer-review

Ngo, A, Hassager, C, Thyregod, HGH, Søndergaard, L, Olsen, PS, Steinbrüchel, D, Hansen, PB, Kjærgaard, J, Winther-Jensen, M & Ihlemann, N 2018, 'Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses', European Heart Journal Cardiovascular Imaging, vol. 19, no. 1, pp. 39-46. https://doi.org/10.1093/ehjci/jew321

Ngo A, Hassager C, Thyregod HGH, Søndergaard L, Olsen PS, Steinbrüchel D et al. Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses. European Heart Journal Cardiovascular Imaging. 2018;19(1):39-46. doi: 10.1093/ehjci/jew321

Ngo, Anh ; Hassager, Christian ; Thyregod, Hans Gustav Hørsted et al. / Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses. In: European Heart Journal Cardiovascular Imaging. 2018 ; Vol. 19, No. 1. pp. 39-46.

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abstract = "Aims Patients with severe aortic stenosis (AS) can be considered for treatment with either transcatheter (TAVR) or surgical aortic valve replacement (SAVR). The purpose of this study was to compare left ventricular (LV) remodeling in patients with AS after treatment with TAVR or SAVR. Methods and results This is an echocardiographic substudy of the NOTION trial, a randomized all-comers trial comparing TAVR with SAVR in patients above 70 years of age. Transthoracic echocardiograms were performed at baseline, 3 and 12 months after TAVR and SAVR. About 232 patients were included in the study, 120 were randomized to TAVR and 112 to SAVR. From baseline to 12 months post-procedure, aortic valve area (AVA) increased in both groups, but with a larger increase in the TAVR group (0.65 ± 0.04 cm 2 vs. 1.02 ± 0.05 cm 2 for SAVR and TAVR group, P < 0.0001). At 12 months, LV mass regression was more pronounced in the SAVR group as compared with TAVR (17.5% vs. 7.2%, P < 0.001). In the TAVR group at 12 months, end diastolic volume (EDV) increased by 10.2 ± 2.5 ml and, in the SAVR group, EDV decreased by 15.4 ± 2.6 ml with a statistically significant difference between the two groups (P < 0.0001). Paravalvular leakage (PVL) and pacemaker implantations were more common in patients treated with TAVR, which was associated with an increase in EDV (P < 0.01). Conclusion Patients undergoing SAVR had a larger LV mass regression at 1 year compared with patients undergoing TAVR, which may be due to increasing amounts of PVL and pacemakers in the TAVR group. Published on behalf of the European Society of Cardiology. All rights reserved.",

keywords = "aortic stenosis, aortic valve replacement, left ventricular remodelling and paravalvular regurgitation, transcatheter aortic valve implantation",

author = "Anh Ngo and Christian Hassager and Thyregod, {Hans Gustav H{\o}rsted} and Lars S{\o}ndergaard and Olsen, {Peter Skov} and Daniel Steinbr{\"u}chel and Hansen, {Peter Bo} and Jesper Kj{\ae}rgaard and Mathilde Winther-Jensen and Nikolaj Ihlemann",

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T1 - Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses

AU - Ngo, Anh

AU - Hassager, Christian

AU - Thyregod, Hans Gustav Hørsted

AU - Søndergaard, Lars

AU - Olsen, Peter Skov

AU - Steinbrüchel, Daniel

AU - Hansen, Peter Bo

AU - Kjærgaard, Jesper

AU - Winther-Jensen, Mathilde

AU - Ihlemann, Nikolaj

PY - 2018

Y1 - 2018

N2 - Aims Patients with severe aortic stenosis (AS) can be considered for treatment with either transcatheter (TAVR) or surgical aortic valve replacement (SAVR). The purpose of this study was to compare left ventricular (LV) remodeling in patients with AS after treatment with TAVR or SAVR. Methods and results This is an echocardiographic substudy of the NOTION trial, a randomized all-comers trial comparing TAVR with SAVR in patients above 70 years of age. Transthoracic echocardiograms were performed at baseline, 3 and 12 months after TAVR and SAVR. About 232 patients were included in the study, 120 were randomized to TAVR and 112 to SAVR. From baseline to 12 months post-procedure, aortic valve area (AVA) increased in both groups, but with a larger increase in the TAVR group (0.65 ± 0.04 cm 2 vs. 1.02 ± 0.05 cm 2 for SAVR and TAVR group, P < 0.0001). At 12 months, LV mass regression was more pronounced in the SAVR group as compared with TAVR (17.5% vs. 7.2%, P < 0.001). In the TAVR group at 12 months, end diastolic volume (EDV) increased by 10.2 ± 2.5 ml and, in the SAVR group, EDV decreased by 15.4 ± 2.6 ml with a statistically significant difference between the two groups (P < 0.0001). Paravalvular leakage (PVL) and pacemaker implantations were more common in patients treated with TAVR, which was associated with an increase in EDV (P < 0.01). Conclusion Patients undergoing SAVR had a larger LV mass regression at 1 year compared with patients undergoing TAVR, which may be due to increasing amounts of PVL and pacemakers in the TAVR group. Published on behalf of the European Society of Cardiology. All rights reserved.

AB - Aims Patients with severe aortic stenosis (AS) can be considered for treatment with either transcatheter (TAVR) or surgical aortic valve replacement (SAVR). The purpose of this study was to compare left ventricular (LV) remodeling in patients with AS after treatment with TAVR or SAVR. Methods and results This is an echocardiographic substudy of the NOTION trial, a randomized all-comers trial comparing TAVR with SAVR in patients above 70 years of age. Transthoracic echocardiograms were performed at baseline, 3 and 12 months after TAVR and SAVR. About 232 patients were included in the study, 120 were randomized to TAVR and 112 to SAVR. From baseline to 12 months post-procedure, aortic valve area (AVA) increased in both groups, but with a larger increase in the TAVR group (0.65 ± 0.04 cm 2 vs. 1.02 ± 0.05 cm 2 for SAVR and TAVR group, P < 0.0001). At 12 months, LV mass regression was more pronounced in the SAVR group as compared with TAVR (17.5% vs. 7.2%, P < 0.001). In the TAVR group at 12 months, end diastolic volume (EDV) increased by 10.2 ± 2.5 ml and, in the SAVR group, EDV decreased by 15.4 ± 2.6 ml with a statistically significant difference between the two groups (P < 0.0001). Paravalvular leakage (PVL) and pacemaker implantations were more common in patients treated with TAVR, which was associated with an increase in EDV (P < 0.01). Conclusion Patients undergoing SAVR had a larger LV mass regression at 1 year compared with patients undergoing TAVR, which may be due to increasing amounts of PVL and pacemakers in the TAVR group. Published on behalf of the European Society of Cardiology. All rights reserved.

KW - aortic stenosis

KW - aortic valve replacement

KW - left ventricular remodelling and paravalvular regurgitation

KW - transcatheter aortic valve implantation

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DO - 10.1093/ehjci/jew321

M3 - Journal article

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