Comparison of cardiac energetics after transcatheter and surgical aortic valve replacements

Yoshiyuki Yamashita, Yoshihisa Tanoue, Hiromichi Sonoda, Tomoki Ushijima, Satoshi Kimura, Yasuhisa Oishi, Hideki Tatewaki, Kenichi Hiasa, Takeshi Arita, Akira Shiose

研究成果: ジャーナルへの寄稿学術誌査読

1 被引用数 (Scopus)


OBJECTIVES: The effect of transcatheter aortic valve replacement (TAVR) on cardiac energetics has not been described. We compared changes in cardiac energetics after TAVR with those after surgical aortic valve replacement (SAVR). METHODS: We retrospectively estimated end-systolic elastance (Ees) and effective arterial elastance (Ea) using blood pressure and left ventricular (LV) volume obtained from echocardiography. LV efficiency [ventriculoarterial coupling (Ea/Ees) and the stroke work to pressure-volume area ratio (SW/PVA)] was calculated. Measurements were taken before, 1 week after and 1 year after bioprosthetic aortic valve replacement (TAVR, n = 56; SAVR, n = 61) in patients with severe aortic stenosis and preserved ejection fraction. RESULTS: Patients with TAVR had a lower aortic valve pressure gradient and larger stroke volume 1 week after the procedure than those with SAVR. Ea was more markedly decreased, and LV efficiency was significantly improved 1 week after TAVR (SW/PVA 68.1% ± 8.4% to 72.0% ± 8.5%, P < 0.001), but LV efficiency was unchanged 1 week after SAVR (SW/PVA 70.1% ± 7.4% to 69.1% ± 8.0%). LV efficiency was improved 1 year after both procedures (SW/PVA 75.5% ± 6.1% in TAVR; 74.7% ± 6.4% in SAVR). CONCLUSIONS: TAVR decreases the transvalvular pressure gradient further without deteriorating stroke volume in the early postoperative period, which is accompanied by early improvement in afterload and LV efficiency compared with SAVR. Improvement in LV efficiency at mid-term follow-up is satisfactory after both procedures.

ジャーナルInteractive cardiovascular and thoracic surgery
出版ステータス出版済み - 4月 1 2019

!!!All Science Journal Classification (ASJC) codes

  • 外科
  • 呼吸器内科
  • 循環器および心血管医学


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