Journal article

Publication year: 2014

Pages: 349-357

Journal: Journal of the American College of Cardiology

Volume number: 64

Issue number: 4

ISSN: 0735-1097

eISSN: 1558-3597

Open access status: Bronze

DOI Link: https://doi.org/10.1016/j.jacc.2014.03.052

Publisher: Elsevier

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

Harvard Citation style: Kim, 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 Citation style: Kim, 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