Impact of TAVR on myocardial injury and ventricular function in elderly patients with intermediate-high risk severe aortic stenosis
Wang Lei
He Yinge
Abstract：Objective To investigate the effects of transcatheter aortic valve replacement(TAVR)on myocardial injury,ventricular function and end-point events in the elderly patients with inter-mediate-high risk severe aortic stenosis(AS).Methods Clinical data of 196 elderly patients with intermediate-high risk severe AS admitted to our department from January 2019 to June 2022 were collected,and according to surgical methods,they were divided into TAVR group(104 cases)and surgical aortic valve replacement(SAVR)group(92 cases).Myocardial injury(AST,LDH,cTnT,CK-MB),ventricular function(LVEDD,LVEF,MPG,Vmax,LVMI),and incidence of end-point events were compared between the two groups.Results In 3 d and 1 week postopera-tively,the TAVR group had significantly lower AST[(130.45±15.21)U/L vs(136.23±16.42)U/L,(86.52±10.24)U/L vs(91.32±11.16)U/L,P＜0.05],LHD[(356.32±20.45)U/L vs(372.24±23.12)U/L,(223.12±22.25)U/L vs(240.36±24.12)U/L,P＜0.05],cTnT[(0.96±0.17)μg/L vs(1.01±0.16)µg/L,(0.64±0.16)μg/L vs(0.69±0.15)μg/L,P＜0.05]and CK-MB[(65.36±7.12)KU/L vs(68.15±7.35)KU/L,(36.14±5.15)KU/L vs(37.86±5.24)KU/L,P＜0.05]levels than the SAVR group.In 1 and 6 months after operation,the values of LVEDD[(58.02±6.42)mm vs(55.13±6.24)mm,(46.32±6.12)mm vs(43.72±6.30)mm,P＜0.05],LVEF[(53.35±5.15)％vs(51.10±5.23)％,(64.02±5.21)％vs 61.82±5.13)％,P＜0.05],MPG[(15.04±2.41)mm Hg vs(13.92±2.35)mm Hg,(18.35±3.12)mm Hg vs(16.15±2.43)mm Hg,P＜0.05]and LVMI[(141.21±16.54)g/m2 vs(132.41±15.64)g/m2,(130.42±15.23)g/m2 vs(124.15±14.62)g/m2,P＜0.05]were obviously higher,while the Vmax value was notably lower in the TAVR group than the SAVR group[(2.21±0.45)m/s vs(2.36±0.48)m/s,(2.04±0.42)m/s vs(2.21±0.45)m/s,P＜0.05].In the follow-up of 12 months,the incidence of new-onset atrial fibrillation(7.69％vs 21.74％,x2=7.866,P=0.005)was remarkably lower,and the incidences of new-onset conduction block(23.08％vs 9.78％,x2=6.162,P=0.013)and perival-vular leakage(14.42％vs 4.35％,x2=5.661,P=0.017)were statistically higher in the TAVR group than the SAVR group.Conclusion TAVR can alleviate myocardial injury and improve ven-tricular function in elderly patients with intermediate-high risk severe AS.But,attention should be paid to preventing the risk of new-onset conduction block and perivalvular leakage.
Keywords：aortic valve stenosisventricular functionmyocardial injurytranscatheter aortic valve replacement
Publication Date：2024-12-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1419-1423 )