CMR quantitation of change in mitral regurgitation following transcatheter aortic valve replacement (TAVR): impact on left ventricular reverse remodeling and outcome

• DOI: 10.1007/s10554-018-1441-y
• Publication Date: 2018-09-04T03:58:11Z
• Authors: Pei G. Chew; Laura E. Dobson; Pankaj Garg; Timothy A. Fairbairn; Tarique A. Musa; Akhlaque Uddin; Peter P. Swoboda; James R. Foley; Graham J. Fent; Louise A. E. Brown; Sebastian Onciul; Sven Plein; Daniel J. Blackman; John P. Greenwood
• Keywords: Valve replacement; Concomitant; Ventricular remodeling

Current echocardiographic data reporting the impact of concomitant mitral regurgitation (MR) on outcome in patients who undergo transcatheter aortic valve replacement (TAVR) are conflicting. Using cardiovascular magnetic resonance (CMR) imaging, this study aimed to assess MR severity cardiac reverse remodeling and patient outcome. 85 undergoing TAVR with CMR pre- 6 m post-TAVR were evaluated. The protocol included cines for left (LV) right ventricular (RV) volumes, flow assessment, myocardial scar assessment by late gadolinium enhancement (LGE). Patients dichotomised according fraction at baseline ('non-significant' vs 'significant') followed up a median duration 3 years. Forty-two (49%) had 'significant MR' baseline; they similar LV RV size function compared 'non-significant group but greater mass baseline. In those significant baseline, 77% (n = 32) reduction post-TAVR, moving them into 'non-significant' category 6-months, an overall from 34 17% (p < 0.001). Improvement was not associated more favourable when 'non-improvers'. Significant increased mortality follow-up. is common improves majority post-procedure. mortality.