Myocardial injury following transcatheter aortic valve implantation : insights from delayed-enhancement cardiovascular magnetic resonance

Authors: Ribeiro, Henrique BarbosaLarose, Éric; Paz Ricapito, Maria de la; Le Ven, FlorentNombela-Franco, LuisUrena Alcazar, MarinaAllende, RicardoAmat Santos, Ignacio J.Dahou, AbdellazizCapoulade, RomainClavel, Marie-AnnickMohammadi, SiamakParadis, Jean-MichelDe Larochellière, RobertDoyle, DanielDumont, ÉricPibarot, PhilippeRodés-Cabau, Josep
Abstract: Aims: The aim of this study was to evaluate the presence, localisation and extent of myocardial injury as determined by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) imaging in patients undergoing transcatheter aortic valve implantation (TAVI). Methods and results: A total of 37 patients, who underwent successful TAVI with a balloon-expandable valve (transapical [TA], n=11; non-TA, n=26), were included. Cardiac biomarker (CK-MB and cTnT) lev- els were determined at baseline and following TAVI. CMR was performed within a week before and within 30 days following TAVI. Some increase in cardiac biomarkers was detected in 97% of the patients as deter- mined by a rise in cTnT, and in 49% of the patients as determined by a rise in CK-MB. Following TAVI, no new myocardial necrosis defects were observed with the non-TA approach. Nonetheless, all patients who underwent TAVI through the TA approach had new focal myocardial necrosis in the apex, with a median myo-cardial extent and necrotic mass of 5% [2.0-7.0] and 3.5 g [2.3-4.5], respectively. Conclusions: Although some increase in cardiac biomarkers of myocardial injury was systematically detected following TAVI, new myocardial necrosis as evaluated by CMR was observed only in patients undergoing the procedure through the TA approach, involving ~5% of the myocardium in the apex.
Document Type: Article de recherche
Issue Date: 1 June 2015
Open Access Date: 26 September 2016
Document version: VoR
This document was published in: EuroIntervention, Vol. 11 (2), 205-213 (2015)
Alternative version: 10.4244/EIJV11I2A39
Collection:Articles publiés dans des revues avec comité de lecture

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