In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

Member Benefit

This content is only available year-round to ESC Professional Members, Fellows of the ESC, and Young Combined Members

Short-term decrease of left atrial size predicts clinical outcome in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement

Session Poster Session 4

Speaker Roberta De Rosa

Event : ESC Congress 2019

  • Topic : valvular, myocardial, pericardial, pulmonary, congenital heart disease
  • Sub-topic : Aortic Valve Stenosis
  • Session type : Poster Session

Authors : R De Rosa (Salerno,IT), M-I Murray (Frankfurt am Main,DE), D Schranz (Frankfurt am Main,DE), S Mas-Peiro (Frankfurt am Main,DE), A Esmaeili (Frankfurt am Main,DE), AM Zeiher (Frankfurt am Main,DE), S Fichtlscherer (Frankfurt am Main,DE), M Vasa-Nicotera (Frankfurt am Main,DE)

Authors:
R. De Rosa1 , M.-I. Murray2 , D. Schranz3 , S. Mas-Peiro2 , A. Esmaeili3 , A.M. Zeiher2 , S. Fichtlscherer2 , M. Vasa-Nicotera2 , 1University of Salerno - Salerno - Italy , 2Goethe University Hospital - Frankfurt am Main - Germany , 3Hessen Pediatric Heart Center Giessen & Frankfurt - Frankfurt am Main - Germany ,

Topic(s):
Aortic Valve Stenosis

Citation:
European Heart Journal ( 2019 ) 40 ( Supplement ), 2301

Background: Increased left atrium (LA) size is a hallmark of severe aortic stenosis (AS) and is associated with adverse patients' cardiovascular outcome. Whether transcatheter aortic valve replacement (TAVR) may lead to a decrease in LA size is not known. Aim: We investigated whether TAVR results in a short-term decrease in LA size and whether such decrease may predict patients' clinical outcome.

Methods: 104 consecutive patients with severe symptomatic AS and dilated LA undergoing TAVR were enrolled. LA volume was assessed by echocardiography before and shortly after TAVR (median time: 7 days). Composite rate of death and hospitalization for acutely decompensated heart failure (HF) was recorded and clinical status was assessed through NYHA- class evaluation at 12 months median follow-up.

Results: After TAVR, 49 patients (47%) demonstrated a decrease in LA volume. Despite a similar baseline NYHA class, patients with decrease in LA size had significant better improvement in clinical status respect to patients with unvaried LA size (NYHA post: 1.2±0.6 vs 1.8±1.1, p=0.001; NYHA reduction: −1.6±0.9 vs −0.9±1.0, p=0.002, respectively). Moreover, these patients had a significantly reduced rate of death or HF-hospitalization (4 vs 29%, p=0.001) and a significantly longer event-free-survival from Kaplan-Meier curves (p=0.003). COX regression analysis showed that, among echocardiographic parameters, decrease in LA-size was an independent predictor of clinical outcome (HR: 0.149, CI: 0.034–0.654, p=0.012).

Conclusions: The lack of decrease in LA size shortly after TAVR is associated with significantly higher rates of death and HF-hospitalization, as well as with impaired improvement in clinical status during long-term follow-up.

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now
logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are