Effect of aortic angle on postoperative reverse left ventricular structural remodeling in patients undergoing transcatheter aortic valve replacement
10.3969/j.issn.1009-0126.2025.05.013
- VernacularTitle:主动脉成角对经导管主动脉瓣置换术患者术后左心室结构逆重构的影响
- Author:
Yingjie WANG
1
;
Bin NING
1
Author Information
1. 236000 蚌埠医科大学附属阜阳医院(阜阳市人民医院)心血管内科
- Publication Type:Journal Article
- Keywords:
aortic valve stenosis;
ventricular remodeling;
transcatheter aortic valve replacement
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(5):601-605
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between left ventricular(LV)structural and functional remodeling and aortic angle(AA)after transcatheter aortic valve replacement(TAVR)in patients with severe aortic stenosis.Methods A retrospective study was conducted on 53 pa-tients undergoing TAVR admitted to our department from May 2021 to May 2024.According to their AA assessed by coronary CT angiography(CTA)preoperatively,they was divided into treat-ment groups 1(AA＜50°,21 cases)and 2(AA≥50°,32 cases).General clinical data,indicators of coronary CTA and cardiac ultrasound parameters,including LV end-diastolic dimension(LVEDD),relative wall thickness(RWT),LV mass(LVM)and its index(LVMI),and LV peak systolic meridional wall stress(Pσm),were collected to assess the LV reverse remodeling at 1 and 6 months after surgery.Results Preoperative RWT was significantly higher and AA was obviously lower in the treatment group 1 than the treatment group 2(P＜0.05,P＜0.01).At 1 and 6 months after surgery,LVMI and Pσm were notably decreased in both groups than the levels be-fore operation(P＜0.05,P＜0.01).When compared with the treatment group 2,the treatment group 1 had significantly lower mean transvalvular pressure difference at 1 month postoperative-ly,thicker RWT at 6 months postoperatively,and lower mean transvalvular pressure difference,LVEDD,LVM,LVMI and Pσm(P＜0.05,P＜0.01).Greenhouse-Geisser correction showed that significant differences were observed in LVMI(F=37.937,P=0.001)and Pσm(F=40.169,P=0.001)over time,and there was a significant interaction between time and group(F=4.154,P=0.027;F=4.771,P=0.015).The main effect of RWT-time and the interaction between time and group were not significant(F=0.490,P=0.579;F=1.563,P=0.218).Conclusion For patients with severe aortic stenosis after TAVR,significant reverse remodeling is observed in the LV structure as early as 1 month after surgery,and these changes are more pronounced at 6 months postoperatively than preoperatively.In addition,there is a strong correlation between AA and post-operative changes in reverse remodeling of LV structure.
