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

Authors: Ledwoch, Jakob; Fröhlich, Carolin; Olbrich, Ida; Poch, Felix; Thalmann, Ruth; Fellner, Carmen; Bradaric, Christian; +3 Authors

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

Abstract

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.

Country
Germany
Keywords

Male, Original Paper, Ventricular Remodeling, Female [MeSH] ; Follow-Up Studies [MeSH] ; Aged [MeSH] ; Atrial Fibrillation/complications [MeSH] ; Postoperative Complications/mortality [MeSH] ; Atrial Fibrillation/mortality [MeSH] ; Humans [MeSH] ; Prospective Studies [MeSH] ; Left ventricular mass ; Treatment Outcome [MeSH] ; Ventricular Remodeling/physiology [MeSH] ; Aortic Valve/surgery [MeSH] ; Postoperative Complications/epidemiology [MeSH] ; Atrial fibrillation ; Hospitalization/statistics ; TAVR ; Male [MeSH] ; Transcatheter Aortic Valve Replacement/methods [MeSH] ; Remodeling ; Echocardiography [MeSH] ; Original Paper, Hospitalization, Transcatheter Aortic Valve Replacement, Postoperative Complications, Treatment Outcome, Echocardiography, Aortic Valve, Atrial Fibrillation, Humans, Female, Prospective Studies, Aged, Follow-Up Studies, ddc: ddc:

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    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
4
Top 10%
Average
Average
Green
hybrid