Transcatheter mitral valve replacement (TMVR) with the Tendyne device (Abbott) results in favourable left-sided chamber remodelling in the majority of patients one month after implantation, a study presented at the ESC 2020 Congress (Virtual, 29 August–1 September) has concluded. The study was simultaneously published in JACC: Cardiovascular Interventions.
Miho Fukui (Minneapolis Heart Institute Foundation, Minneapolis, USA) and colleagues analysed data from patients who underwent TMVR with the Tendyne device between 2015 and 2018, looking at changes in left ventricular end-diastolic volume, ejection fraction, left ventricular mass, left atrial volume, and global longitudinal strain at baseline and one month after TMVR using computed tomographic angiography.
A total of 36 patients (median age 74 years; interquartile range [IQR]: 69‒78 years; 78% men; 86% with secondary mitral regurgitation) were included in the study.
Results presented by Fukui and colleagues showed that there were significant decreases in LV end-diastolic volume (281ml vs. 239ml), LV ejection fraction (37% vs. 30%), LV mass (126g vs. 116g), left atrial volume (171 ml vs. 159 ml), and global longitudinal strain (11% vs. 9%) from baseline to one-month follow-up.
Additionally favourable LV end-diastolic volume reverse remodelling occurred in the majority (30 of 36 patients [83%]), the study team notes. Closer proximity of the Tendyne apical pad to the true apex (24mm vs. 35mm) was predictive of favourable remodelling the study suggests.
“The present investigation is the first CT angiographic study to demonstrate reverse remodelling of the left atrium and left ventricle after TMVR,” Fukui et al write in JACC: Cardiovascular Interventions. The findings, they suggest, could have potential implications for expanding the role of CTA to optimise patient outcomes, selection, and implantation characteristics for the Tendyne system and the field of TMVR. Further studies are required to evaluate the relation among Tendyne apical pad location, reverse remodelling, and its association with clinical outcomes, they suggest.
