The following is a summary of “Concomitant aortic regurgitation predicts better left ventricular reverse remodeling after transcatheter aortic valve replacement,” published in the July 2023 issue of Cardiology by Yang et al.

In the retrospective study, researchers explored the role of epicardial adipose tissue (EAT) and the factors that are responsible after a specific heart valve procedure called transcatheter aortic valve replacement (TAVR) for inadequate left ventricular mass index (LVMi) regression.

The study enrolled 152 patients into two groups with a median age of 74 who underwent echocardiographic assessments and multi-slice computed tomography (MSCT) for one year after TAVR. They calculated the LVMi changes, volume, and average CT attenuation of EAT from the start to the one-year follow-up. The division of patients was based on LVMi change, using a 15% cutoff.

Of the participants, 56.6% were male (interquartile range [IQR] 69–78 years. At one year, LVMi dropped (P < 0.0001); at the same time, EAT volume raised, and the average CT attenuation diminished (both P < 0.0001). Baseline atrial fibrillation (P = 0.042),  aortic regurgitation (AR) > mild (P = 0.001), mitral regurgitation ≥ mild (P = 0.006), the alteration in the average CT density of EAT (P = 0.026) showed differences between the LVMi reduction of ≥15% and <15%. Mild or greater AR at the beginning was the sole statistically significant factor in multivariate regression predicting a decrease in LVMi of less than 15% after one year < 15% at one year (OR 0.33, 95% CI: 0.13 to 0.84, P = 0.021).

The study concluded that concomitant moderate or severe AR could indicate improved left ventricular reverse remodeling following TAVR.

Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-023-03377-7