Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies
Abstract Background Transcatheter aortic valve replacement (TAVR) is increasingly used to treat patients with severe aortic stenosis (AS). Cardiovascular magnetic resonance imaging (CMR) provides reliable and reproducible estimates for assessment of cardiac structure and function after TAVR. The goa...
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doaj-75209992ec0b47fba2ae93df72c6032e2020-11-25T03:16:52ZengBMCJournal of Cardiovascular Magnetic Resonance1532-429X2020-06-0122111010.1186/s12968-020-00629-9Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studiesGhazaleh Mehdipoor0Shmuel Chen1Saurav Chatterjee2Pooya Torkian3Ori Ben-Yehuda4Martin B. Leon5Gregg W. Stone6Martin R. Prince7Cardiovascular Research FoundationCardiovascular Research FoundationHoffman Heart Institute, Saint Francis Hospital of the University of ConnecticutShahid Beheshti University of Medical SciencesCardiovascular Research FoundationCardiovascular Research FoundationCardiovascular Research FoundationDepartment of Radiology, Weill Cornell Medical College& New York Presbyterian HospitalAbstract Background Transcatheter aortic valve replacement (TAVR) is increasingly used to treat patients with severe aortic stenosis (AS). Cardiovascular magnetic resonance imaging (CMR) provides reliable and reproducible estimates for assessment of cardiac structure and function after TAVR. The goal of this study was to conduct a systematic review and meta-analysis of the literature to assess left ventricular (LV) volumes, mass and function by CMR after TAVR. Methods Using Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, we searched PubMed and Embase for studies reporting CMR findings before and at least 1 month after TAVR. Main factors of interest were LV end-diastolic volume index (LVEDVi), LV end-systolic volume index (LVESVi), LV mass index (LVMi), and left ventricular ejection fraction (LVEF). Standardized mean differences (SMD) were pooled by random effects meta-analytic techniques. Results Of 453 screened publications, 10 studies (published between 2012 and 2018) were included. A total of 305 patients completed pre- and post-TAVR follow-up CMR (mean age range 78.6–85.0 years, follow-up range 6–15 months). Random effects analysis showed TAVR resulted in reduced LVEDVi (SMD: -0.25, 95% CI: − 0.43 to − 0.07, P = 0.006), LVESVi (SMD: -0.24, 95% CI: − 0.44 to − 0.05, P = 0.01), LVMi (SMD: -0.82, 95% CI: − 1.0 to − 0.63, P < 0.001) and increased LVEF (SMD: 22, 95% CI: 6 to 38%, P = 0.006). Heterogeneity across studies was low (I2: 0%, Pheterogeneity > 0.05 for all). The median reduction was 4 ml/m2 (IQR: 3.1 to 8.2) for LVEDVi, 5 ml/m2 (IQR: 3.0 to 6.0) for LVESVi, and 15.1 g/m2 (IQR: 11.8 to 18.3) for LVMi. The median increase for LVEF was 3.4% (IQR 1.0 to 4.6%). Conclusions CMR demonstrates reverse LV remodeling occurrs within 6–15 months after TAVR, with reductions in LVEDVi, LVESVi and LVMi, and increased LVEF.http://link.springer.com/article/10.1186/s12968-020-00629-9Transcatheter aortic valve replacement (TAVR)Transcatheter aortic valve implantation (TAVI)Aortic stenosisMagnetic resonance imaging (MRI)Cardiac structure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ghazaleh Mehdipoor Shmuel Chen Saurav Chatterjee Pooya Torkian Ori Ben-Yehuda Martin B. Leon Gregg W. Stone Martin R. Prince |
spellingShingle |
Ghazaleh Mehdipoor Shmuel Chen Saurav Chatterjee Pooya Torkian Ori Ben-Yehuda Martin B. Leon Gregg W. Stone Martin R. Prince Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies Journal of Cardiovascular Magnetic Resonance Transcatheter aortic valve replacement (TAVR) Transcatheter aortic valve implantation (TAVI) Aortic stenosis Magnetic resonance imaging (MRI) Cardiac structure |
author_facet |
Ghazaleh Mehdipoor Shmuel Chen Saurav Chatterjee Pooya Torkian Ori Ben-Yehuda Martin B. Leon Gregg W. Stone Martin R. Prince |
author_sort |
Ghazaleh Mehdipoor |
title |
Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies |
title_short |
Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies |
title_full |
Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies |
title_fullStr |
Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies |
title_full_unstemmed |
Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies |
title_sort |
cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies |
publisher |
BMC |
series |
Journal of Cardiovascular Magnetic Resonance |
issn |
1532-429X |
publishDate |
2020-06-01 |
description |
Abstract Background Transcatheter aortic valve replacement (TAVR) is increasingly used to treat patients with severe aortic stenosis (AS). Cardiovascular magnetic resonance imaging (CMR) provides reliable and reproducible estimates for assessment of cardiac structure and function after TAVR. The goal of this study was to conduct a systematic review and meta-analysis of the literature to assess left ventricular (LV) volumes, mass and function by CMR after TAVR. Methods Using Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, we searched PubMed and Embase for studies reporting CMR findings before and at least 1 month after TAVR. Main factors of interest were LV end-diastolic volume index (LVEDVi), LV end-systolic volume index (LVESVi), LV mass index (LVMi), and left ventricular ejection fraction (LVEF). Standardized mean differences (SMD) were pooled by random effects meta-analytic techniques. Results Of 453 screened publications, 10 studies (published between 2012 and 2018) were included. A total of 305 patients completed pre- and post-TAVR follow-up CMR (mean age range 78.6–85.0 years, follow-up range 6–15 months). Random effects analysis showed TAVR resulted in reduced LVEDVi (SMD: -0.25, 95% CI: − 0.43 to − 0.07, P = 0.006), LVESVi (SMD: -0.24, 95% CI: − 0.44 to − 0.05, P = 0.01), LVMi (SMD: -0.82, 95% CI: − 1.0 to − 0.63, P < 0.001) and increased LVEF (SMD: 22, 95% CI: 6 to 38%, P = 0.006). Heterogeneity across studies was low (I2: 0%, Pheterogeneity > 0.05 for all). The median reduction was 4 ml/m2 (IQR: 3.1 to 8.2) for LVEDVi, 5 ml/m2 (IQR: 3.0 to 6.0) for LVESVi, and 15.1 g/m2 (IQR: 11.8 to 18.3) for LVMi. The median increase for LVEF was 3.4% (IQR 1.0 to 4.6%). Conclusions CMR demonstrates reverse LV remodeling occurrs within 6–15 months after TAVR, with reductions in LVEDVi, LVESVi and LVMi, and increased LVEF. |
topic |
Transcatheter aortic valve replacement (TAVR) Transcatheter aortic valve implantation (TAVI) Aortic stenosis Magnetic resonance imaging (MRI) Cardiac structure |
url |
http://link.springer.com/article/10.1186/s12968-020-00629-9 |
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