Subclinical leaflet thrombosis after transcatheter aortic valve implantation: no association with left ventricular reverse remodeling at 1-year follow-up

Springer Science and Business Media LLC - 2022
Jurriën H. Kuneman1, Gurpreet K. Singh1, Nicolaj C. Hansson2, Laura Fusini3, Steen Hvitfeldt Poulsen2, Federico Fortuni4, E. Mara Vollema1, Anders Lehmann Dahl Pedersen2, Andrea Annoni3, Bjarne Linde Nørgaard2, Gianluca Pontone3, Nina Ajmone Marsan1, Victoria Delgado1, Jeroen J. Bax1, Juhani Knuuti5
1Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
2Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
3Department of Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, Milan, Italy
4Department of Cardiology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
5Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland

Tóm tắt

AbstractHypo-attenuated leaflet thickening (HALT) of transcatheter aortic valves is detected on multidetector computed tomography (MDCT) and reflects leaflet thrombosis. Whether HALT affects left ventricular (LV) reverse remodeling, a favorable effect of LV afterload reduction after transcatheter aortic valve implantation (TAVI) is unknown. The aim of this study was to examine the association of HALT after TAVI with LV reverse remodeling. In this multicenter case–control study, patients with HALT on MDCT were identified, and patients without HALT were propensity matched for valve type and size, LV ejection fraction (LVEF), sex, age and time of scan. LV dimensions and function were assessed by transthoracic echocardiography before and 12 months after TAVI. Clinical outcomes (stroke or transient ischemic attack, heart failure hospitalization, new-onset atrial fibrillation, all-cause mortality) were recorded. 106 patients (age 81 ± 7 years, 55% male) with MDCT performed 37 days [IQR 32–52] after TAVI were analyzed (53 patients with HALT and 53 matched controls). Before TAVI, all echocardiographic parameters were similar between the groups. At 12 months follow-up, patients with and without HALT showed a significant reduction in LV end-diastolic volume, LV end-systolic volume and LV mass index (from 125 ± 37 to 105 ± 46 g/m2, p = 0.001 and from 127 ± 35 to 101 ± 27 g/m2, p < 0.001, respectively, p for interaction = 0.48). Moreover, LVEF improved significantly in both groups. In addition, clinical outcomes were not statistically different. Improvement in LVEF and LV reverse remodeling at 12 months after TAVI were not limited by HALT.

Từ khóa


Tài liệu tham khảo

Grossman W, Jones D, McLaurin LP (1975) Wall stress and patterns of hypertrophy in the human left ventricle. J Clin Invest 56:56–64. https://doi.org/10.1172/JCI108079

Otto CM, Prendergast B (2014) Aortic-valve stenosis–from patients at risk to severe valve obstruction. N Engl J Med 371:744–756. https://doi.org/10.1056/NEJMra1313875

Orsinelli DA, Aurigemma GP, Battista S, Krendel S, Gaasch WH (1993) Left ventricular hypertrophy and mortality after aortic valve replacement for aortic stenosis. A high risk subgroup identified by preoperative relative wall thickness. J Am Coll Cardiol 22:1679–1683. https://doi.org/10.1016/0735-1097(93)90595-r

Kang DH, Park SJ, Lee SA, Lee S, Kim DH, Kim HK, Yun SC, Hong GR, Song JM, Chung CH, Song JK, Lee JW, Park SW (2020) Early surgery or conservative care for asymptomatic aortic stenosis. N Engl J Med 382:111–119. https://doi.org/10.1056/NEJMoa1912846

Vollema EM, Singh GK, Prihadi EA, Regeer MV, Ewe SH, Ng ACT, Mertens BJA, Klautz RJM, Ajmone Marsan N, Bax JJ, Delgado V (2019) Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation. Eur Heart J Cardiovasc Imaging 20:1105–1111. https://doi.org/10.1093/ehjci/jez049

Kamperidis V, Joyce E, Debonnaire P, Katsanos S, van Rosendael PJ, van der Kley F, Sianos G, Bax JJ, Ajmone Marsan N, Delgado V (2014) Left ventricular functional recovery and remodeling in low-flow low-gradient severe aortic stenosis after transcatheter aortic valve implantation. J Am Soc Echocardiogr 27:817–825. https://doi.org/10.1016/j.echo.2014.04.021

Al-Hawwas M, Marmagkiolis K, Mehta JL (2017) The impact of transcatheter aortic valve implantation and surgical aortic valve replacement on left ventricular remodeling. Am J Cardiol 120:1198–1202. https://doi.org/10.1016/j.amjcard.2017.06.066

Kim SJ, Samad Z, Bloomfield GS, Douglas PS (2014) A critical review of hemodynamic changes and left ventricular remodeling after surgical aortic valve replacement and percutaneous aortic valve replacement. Am Heart J 168(150–159):e151-157. https://doi.org/10.1016/j.ahj.2014.04.015

Ali A, Patel A, Ali Z, Abu-Omar Y, Saeed A, Athanasiou T, Pepper J (2011) Enhanced left ventricular mass regression after aortic valve replacement in patients with aortic stenosis is associated with improved long-term survival. J Thorac Cardiovasc Surg 142:285–291. https://doi.org/10.1016/j.jtcvs.2010.08.084

Une D, Mesana L, Chan V, Maklin M, Chan R, Masters RG, Mesana TG, Ruel M (2015) Clinical impact of changes in left ventricular function after aortic valve replacement: analysis from 3112 patients. Circulation 132:741–747. https://doi.org/10.1161/CIRCULATIONAHA.115.015371

Lindman BR, Stewart WJ, Pibarot P, Hahn RT, Otto CM, Xu K, Devereux RB, Weissman NJ, Enriquez-Sarano M, Szeto WY, Makkar R, Miller DC, Lerakis S, Kapadia S, Bowers B, Greason KL, McAndrew TC, Lei Y, Leon MB, Douglas PS (2014) Early regression of severe left ventricular hypertrophy after transcatheter aortic valve replacement is associated with decreased hospitalizations. J Am Coll Cardiol Intv 7:662–673. https://doi.org/10.1016/j.jcin.2014.02.011

Ng ACT, Holmes DR, Mack MJ, Delgado V, Makkar R, Blanke P, Leipsic JA, Leon MB, Bax JJ (2020) Leaflet immobility and thrombosis in transcatheter aortic valve replacement. Eur Heart J 41:3184–3197. https://doi.org/10.1093/eurheartj/ehaa542

Vollema EM, Kong WKF, Katsanos S, Kamperidis V, van Rosendael PJ, van der Kley F, de Weger A, Ajmone Marsan N, Delgado V, Bax JJ (2017) Transcatheter aortic valve thrombosis: the relation between hypo-attenuated leaflet thickening, abnormal valve haemodynamics, and stroke. Eur Heart J 38:1207–1217. https://doi.org/10.1093/eurheartj/ehx031

Makkar RR, Fontana G, Jilaihawi H, Chakravarty T, Kofoed KF, De Backer O, Asch FM, Ruiz CE, Olsen NT, Trento A, Friedman J, Berman D, Cheng W, Kashif M, Jelnin V, Kliger CA, Guo H, Pichard AD, Weissman NJ, Kapadia S, Manasse E, Bhatt DL, Leon MB, Sondergaard L (2015) Possible subclinical leaflet thrombosis in bioprosthetic aortic valves. N Engl J Med 373:2015–2024. https://doi.org/10.1056/NEJMoa1509233

Hansson NC, Grove EL, Andersen HR, Leipsic J, Mathiassen ON, Jensen JM, Jensen KT, Blanke P, Leetmaa T, Tang M, Krusell LR, Klaaborg KE, Christiansen EH, Terp K, Terkelsen CJ, Poulsen SH, Webb J, Botker HE, Norgaard BL (2016) Transcatheter aortic valve thrombosis: incidence, predisposing factors, and clinical implications. J Am Coll Cardiol 68:2059–2069. https://doi.org/10.1016/j.jacc.2016.08.010

Sondergaard L, De Backer O, Kofoed KF, Jilaihawi H, Fuchs A, Chakravarty T, Kashif M, Kazuno Y, Kawamori H, Maeno Y, Bieliauskas G, Guo H, Stone GW, Makkar R (2017) Natural history of subclinical leaflet thrombosis affecting motion in bioprosthetic aortic valves. Eur Heart J 38:2201–2207. https://doi.org/10.1093/eurheartj/ehx369

Rashid HN, Brown AJ, McCormick LM, Amiruddin AS, Be KK, Cameron JD, Nasis A, Gooley RP (2018) Subclinical leaflet thrombosis in transcatheter aortic valve replacement detected by multidetector computed tomography- a review of current evidence. Circ J 82:1735–1742. https://doi.org/10.1253/circj.CJ-17-1363

Khan JM, Rogers T, Waksman R, Torguson R, Weissman G, Medvedofsky D, Craig PE, Zhang C, Gordon P, Ehsan A, Wilson SR, Goncalves J, Levitt R, Hahn C, Parikh P, Bilfinger T, Butzel D, Buchanan S, Hanna N, Garrett R, Shults C, Garcia-Garcia HM, Kolm P, Satler LF, Buchbinder M, Ben-Dor I, Asch FM (2019) Hemodynamics and subclinical leaflet thrombosis in low-risk patients undergoing transcatheter aortic valve replacement. Circ Cardiovasc Imaging 12:e009608. https://doi.org/10.1161/CIRCIMAGING.119.009608

Pache G, Schoechlin S, Blanke P, Dorfs S, Jander N, Arepalli CD, Gick M, Buettner HJ, Leipsic J, Langer M, Neumann FJ, Ruile P (2016) Early hypo-attenuated leaflet thickening in balloon-expandable transcatheter aortic heart valves. Eur Heart J 37:2263–2271. https://doi.org/10.1093/eurheartj/ehv526

Tang L, Lesser JR, Schneider LM, Burns MR, Gossl M, Garberich R, Niikura H, Witt D, Sorajja P (2019) Prospective evaluation for hypoattenuated leaflet thickening following transcatheter aortic valve implantation. Am J Cardiol 123:658–666. https://doi.org/10.1016/j.amjcard.2018.11.012

Yanagisawa R, Tanaka M, Yashima F, Arai T, Jinzaki M, Shimizu H, Fukuda K, Watanabe Y, Naganuma T, Higashimori A, Mizutani K, Araki M, Tada N, Yamanaka F, Otsuka T, Yamamoto M, Hayashida K (2019) Early and late leaflet thrombosis after transcatheter aortic valve replacement. Circ Cardiovasc Interv 12:e007349. https://doi.org/10.1161/CIRCINTERVENTIONS.118.007349

Del Trigo M, Munoz-Garcia AJ, Wijeysundera HC, Nombela-Franco L, Cheema AN, Gutierrez E, Serra V, Kefer J, Amat-Santos IJ, Benitez LM, Mewa J, Jimenez-Quevedo P, Alnasser S, Garcia Del Blanco B, Dager A, Abdul-Jawad Altisent O, Puri R, Campelo-Parada F, Dahou A, Paradis JM, Dumont E, Pibarot P, Rodes-Cabau J (2016) Incidence, timing, and predictors of valve hemodynamic deterioration after transcatheter aortic valve replacement: multicenter registry. J Am Coll Cardiol 67:644–655. https://doi.org/10.1016/j.jacc.2015.10.097

Issa IF, Dahl JS, Poulsen SH, Waziri F, Pedersen CT, Riber L, Sogaard P, Moller JE (2020) The relation of structural valve deterioration to adverse remodelling and outcome in patients with biological heart valve prostheses. Eur Heart J Cardiovasc Imaging. https://doi.org/10.1093/ehjci/jez317

Blanke P, Weir-McCall JR, Achenbach S, Delgado V, Hausleiter J, Jilaihawi H, Marwan M, Norgaard BL, Piazza N, Schoenhagen P, Leipsic JA (2019) Computed tomography imaging in the context of transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR): an expert consensus document of the society of cardiovascular computed tomography. J Am Coll Cardiol Img 12:1–24. https://doi.org/10.1016/j.jcmg.2018.12.003

Otto CM, Kumbhani DJ, Alexander KP, Calhoon JH, Desai MY, Kaul S, Lee JC, Ruiz CE, Vassileva CM (2017) 2017 ACC expert consensus decision pathway for transcatheter aortic valve replacement in the management of adults with aortic stenosis: a report of the american college of cardiology task force on clinical expert consensus documents. J Am Coll Cardiol 69:1313–1346. https://doi.org/10.1016/j.jacc.2016.12.006

Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1–39):e14. https://doi.org/10.1016/j.echo.2014.10.003

Lancellotti P, Pibarot P, Chambers J, Edvardsen T, Delgado V, Dulgheru R, Pepi M, Cosyns B, Dweck MR, Garbi M, Magne J, Nieman K, Rosenhek R, Bernard A, Lowenstein J, Vieira ML, Rabischoffsky A, Vyhmeister RH, Zhou X, Zhang Y, Zamorano JL, Habib G (2016) Recommendations for the imaging assessment of prosthetic heart valves: a report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 17:589–590. https://doi.org/10.1093/ehjci/jew025

Annoni AD, Andreini D, Pontone G, Mancini ME, Formenti A, Mushtaq S, Baggiano A, Conte E, Guglielmo M, Muscogiuri G, Muratori M, Fusini L, Trabattoni D, Teruzzi G, Coutinho Santos AI, Agrifoglio M, Pepi M (2018) CT angiography prior to TAVI procedure using third-generation scanner with wide volume coverage: feasibility, renal safety and diagnostic accuracy for coronary tree. Br J Radiol 91:20180196. https://doi.org/10.1259/bjr.20180196

Sellers SL, Turner CT, Sathananthan J, Cartlidge TRG, Sin F, Bouchareb R, Mooney J, Norgaard BL, Bax JJ, Bernatchez PN, Dweck MR, Granville DJ, Newby DE, Lauck S, Webb JG, Payne GW, Pibarot P, Blanke P, Seidman MA, Leipsic JA (2019) Transcatheter aortic heart valves: histological analysis providing insight to leaflet thickening and structural valve degeneration. J Am Coll Cardiol Img 12:135–145. https://doi.org/10.1016/j.jcmg.2018.06.028

Jose J, Sulimov DS, El-Mawardy M, Sato T, Allali A, Holy EW, Becker B, Landt M, Kebernik J, Schwarz B, Richardt G, Abdel-Wahab M (2017) Clinical bioprosthetic heart valve thrombosis after transcatheter aortic valve replacement: incidence, characteristics, and treatment outcomes. J Am Coll Cardiol Intv 10:686–697. https://doi.org/10.1016/j.jcin.2017.01.045

Latib A, Naganuma T, Abdel-Wahab M, Danenberg H, Cota L, Barbanti M, Baumgartner H, Finkelstein A, Legrand V, de Lezo JS, Kefer J, Messika-Zeitoun D, Richardt G, Stabile E, Kaleschke G, Vahanian A, Laborde JC, Leon MB, Webb JG, Panoulas VF, Maisano F, Alfieri O, Colombo A (2015) Treatment and clinical outcomes of transcatheter heart valve thrombosis. Circ Cardiovasc Interv. https://doi.org/10.1161/CIRCINTERVENTIONS.114.001779

Chakravarty T, Sondergaard L, Friedman J, De Backer O, Berman D, Kofoed KF, Jilaihawi H, Shiota T, Abramowitz Y, Jorgensen TH, Rami T, Israr S, Fontana G, de Knegt M, Fuchs A, Lyden P, Trento A, Bhatt DL, Leon MB, Makkar RR, Resolve and Investigators S (2017) Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study. Lancet 389:2383–2392. https://doi.org/10.1016/S0140-6736(17)30757-2

Makkar RR, Blanke P, Leipsic J, Thourani V, Chakravarty T, Brown D, Trento A, Guyton R, Babaliaros V, Williams M, Jilaihawi H, Kodali S, George I, Lu M, McCabe JM, Friedman J, Smalling R, Wong SC, Yazdani S, Bhatt DL, Bax J, Kapadia S, Herrmann HC, Mack M, Leon MB (2020) Subclinical leaflet thrombosis in transcatheter and surgical bioprosthetic valves: PARTNER 3 cardiac computed tomography substudy. J Am Coll Cardiol 75:3003–3015. https://doi.org/10.1016/j.jacc.2020.04.043

Ruile P, Minners J, Breitbart P, Schoechlin S, Gick M, Pache G, Neumann FJ, Hein M (2018) Medium-term follow-up of early leaflet thrombosis after transcatheter aortic valve replacement. J Am Coll Cardiol Intv 11:1164–1171. https://doi.org/10.1016/j.jcin.2018.04.006

Casula M, Fortuni F, Ferlini M, Mauri S, Rebuffi C, Rossini R, Ferrario M, Visconti LO (2020) Subclinical leaflet thrombosis after transcatheter aortic valve replacement: a meaningless finding? A systematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. https://doi.org/10.1093/ehjqcco/qcaa047

Szilveszter B, Oren D, Molnar L, Apor A, Nagy AI, Molnar A, Vattay B, Kolossvary M, Karady J, Bartykowszki A, Jermendy AL, Suhai FI, Panajotu A, Maurovich-Horvat P, Merkely B (2019) Subclinical leaflet thrombosis is associated with impaired reverse remodelling after transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging. https://doi.org/10.1093/ehjci/jez256

Thông tin
Thông tin xuất bản

Springer Science and Business Media LLC

Thông tin tác giả