Journalartikel

Detection of Myocardial Injury by CMR After Transcatheter Aortic Valve Replacement


AutorenlisteKim, Won-Keun; Rolf, Andreas; Liebetrau, Christoph; Van Linden, Arnaud; Blumenstein, Johannes; Kempfert, Joerg; Bachmann, Georg; Nef, Holger; Hamm, Christian; Walther, Thomas; Moellmann, Helge

Jahr der Veröffentlichung2014

Seiten349-357

ZeitschriftJournal of the American College of Cardiology

Bandnummer64

Heftnummer4

ISSN0735-1097

eISSN1558-3597

Open Access StatusBronze

DOI Linkhttps://doi.org/10.1016/j.jacc.2014.03.052

VerlagElsevier


Abstract

BACKGROUND Myocardial injury after transcatheter aortic valve replacement (TAVR) is common, but its cause and relationship to the extent of myocardial tissue loss remain unclear.

OBJECTIVES This study sought to examine the incidence and degree of ischemic myocardial damage using cardiac magnetic resonance imaging and myocardial biomarkers in patients undergoing TAVR.

METHODS Patients with severe aortic stenosis (n = 61) underwent cardiac magnetic resonance imaging before and after TAVR for the assessment of new myocardial injury. High-sensitivity cardiac troponin T and creatine kinase-myocardial band were measured before and at 24, 48, and 72 h after TAVR.

RESULTS After TAVR, new myocardial late enhancement (LE) with an ischemic pattern occurred in 11 patients (18%), with a mean mass of 3.7 g (interquartile range: 1.2 to 6 g) or 1.8% (interquartile range: 1.3% to 4.1%) of the left ventricular mass. Patients with new LE had a decreased left ventricular function (ejection fraction: pre, 55.5 +/- 14.1% vs. post, 45.3 +/- 14.9%; p = 0.001). In patients without new LE, no differences were observed (ejection fraction: pre, 53.9 +/- 17.3% vs. post, 54.6 +/- 16.3%; p = NS) after TAVR.

CONCLUSIONS New ischemic-type myocardial LE after TAVR can be observed in a notable proportion of patients and is assumed to be of embolic origin. Patients with new LE feature a significant decrease in left ventricular function at discharge. (C) 2014 by the American College of Cardiology Foundation




Zitierstile

Harvard-ZitierstilKim, W., Rolf, A., Liebetrau, C., Van Linden, A., Blumenstein, J., Kempfert, J., et al. (2014) Detection of Myocardial Injury by CMR After Transcatheter Aortic Valve Replacement, Journal of the American College of Cardiology, 64(4), pp. 349-357. https://doi.org/10.1016/j.jacc.2014.03.052

APA-ZitierstilKim, W., Rolf, A., Liebetrau, C., Van Linden, A., Blumenstein, J., Kempfert, J., Bachmann, G., Nef, H., Hamm, C., Walther, T., & Moellmann, H. (2014). Detection of Myocardial Injury by CMR After Transcatheter Aortic Valve Replacement. Journal of the American College of Cardiology. 64(4), 349-357. https://doi.org/10.1016/j.jacc.2014.03.052



Schlagwörter


CARDIOVASCULAR MAGNETIC-RESONANCEELEVATIONEMBOLISMIMPLANTATIONMagnetic Resonance ImagingMyocardial infarctionTAVR


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