Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes After Transcatheter Aortic Valve Replacement
BackgroundThe clinical implication of new-onset left bundle branch block (LBBB) after transcatheter aortic valve replacement (TAVR) remains controversial. We investigated the impact of new-onset persistent LBBB on reverse cardiac remodeling and clinical outcomes after TAVR.MethodsAmong 478 patients...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.893878/full |
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| author | Kyu Kim Young-Guk Ko Chi Young Shim JiWung Ryu Yong-Joon Lee Jiwon Seo Seung-Jun Lee Iksung Cho Sung-Jin Hong Chul-Min Ahn Jung-Sun Kim Byeong-Keuk Kim Geu-Ru Hong Jong-Won Ha Donghoon Choi Myeong-Ki Hong |
| author_facet | Kyu Kim Young-Guk Ko Chi Young Shim JiWung Ryu Yong-Joon Lee Jiwon Seo Seung-Jun Lee Iksung Cho Sung-Jin Hong Chul-Min Ahn Jung-Sun Kim Byeong-Keuk Kim Geu-Ru Hong Jong-Won Ha Donghoon Choi Myeong-Ki Hong |
| author_sort | Kyu Kim |
| collection | DOAJ |
| description | BackgroundThe clinical implication of new-onset left bundle branch block (LBBB) after transcatheter aortic valve replacement (TAVR) remains controversial. We investigated the impact of new-onset persistent LBBB on reverse cardiac remodeling and clinical outcomes after TAVR.MethodsAmong 478 patients who had undergone TAVR for symptomatic severe aortic stenosis from 2011 to 2021, we analyzed 364 patients after excluding patients with pre-existing intraventricular conduction disturbance or a pacing rhythm before or during the indexed hospitalization for TAVR. Echocardiographic variables of cardiac remodeling at baseline and 1 year after TAVR were comprehensively analyzed. The primary outcome was a composite of cardiovascular death and hospitalization for heart failure. Secondary outcomes were all-cause death and individual components of the primary outcome.ResultNew-onset persistent LBBB occurred in 41 (11.3%) patients after TAVR. The no LBBB group showed a significant increase in the left ventricular (LV) ejection fraction and decreases in LV dimensions, the left atrial volume index, and LV mass index 1 year after TAVR (all p < 0.001). However, the new LBBB group showed no significant changes in these parameters. During a median follow-up of 18.1 months, the new LBBB group experienced a higher incidence of primary outcomes [hazard ratio (HR): 5.03; 95% confidence interval (CI): 2.60–9.73; p < 0.001] and all-cause death (HR: 2.80; 95% CI: 1.38–5.69; p = 0.003). The data were similar after multivariable regression analysis.ConclusionNew-onset persistent LBBB after TAVR is associated with insufficient reverse cardiac remodeling and increased adverse clinical events. |
| first_indexed | 2024-04-14T01:07:32Z |
| format | Article |
| id | doaj.art-abb18bb852174fb898f560450b9394f0 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-14T01:07:32Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-abb18bb852174fb898f560450b9394f02022-12-22T02:21:11ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.893878893878Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes After Transcatheter Aortic Valve ReplacementKyu Kim0Young-Guk Ko1Chi Young Shim2JiWung Ryu3Yong-Joon Lee4Jiwon Seo5Seung-Jun Lee6Iksung Cho7Sung-Jin Hong8Chul-Min Ahn9Jung-Sun Kim10Byeong-Keuk Kim11Geu-Ru Hong12Jong-Won Ha13Donghoon Choi14Myeong-Ki Hong15Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaDivision of Cardiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South KoreaBackgroundThe clinical implication of new-onset left bundle branch block (LBBB) after transcatheter aortic valve replacement (TAVR) remains controversial. We investigated the impact of new-onset persistent LBBB on reverse cardiac remodeling and clinical outcomes after TAVR.MethodsAmong 478 patients who had undergone TAVR for symptomatic severe aortic stenosis from 2011 to 2021, we analyzed 364 patients after excluding patients with pre-existing intraventricular conduction disturbance or a pacing rhythm before or during the indexed hospitalization for TAVR. Echocardiographic variables of cardiac remodeling at baseline and 1 year after TAVR were comprehensively analyzed. The primary outcome was a composite of cardiovascular death and hospitalization for heart failure. Secondary outcomes were all-cause death and individual components of the primary outcome.ResultNew-onset persistent LBBB occurred in 41 (11.3%) patients after TAVR. The no LBBB group showed a significant increase in the left ventricular (LV) ejection fraction and decreases in LV dimensions, the left atrial volume index, and LV mass index 1 year after TAVR (all p < 0.001). However, the new LBBB group showed no significant changes in these parameters. During a median follow-up of 18.1 months, the new LBBB group experienced a higher incidence of primary outcomes [hazard ratio (HR): 5.03; 95% confidence interval (CI): 2.60–9.73; p < 0.001] and all-cause death (HR: 2.80; 95% CI: 1.38–5.69; p = 0.003). The data were similar after multivariable regression analysis.ConclusionNew-onset persistent LBBB after TAVR is associated with insufficient reverse cardiac remodeling and increased adverse clinical events.https://www.frontiersin.org/articles/10.3389/fcvm.2022.893878/fulltranscatheter aortic valve replacementleft bundle branch blockcardiac remodelingprognosisaortic stenosis |
| spellingShingle | Kyu Kim Young-Guk Ko Chi Young Shim JiWung Ryu Yong-Joon Lee Jiwon Seo Seung-Jun Lee Iksung Cho Sung-Jin Hong Chul-Min Ahn Jung-Sun Kim Byeong-Keuk Kim Geu-Ru Hong Jong-Won Ha Donghoon Choi Myeong-Ki Hong Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes After Transcatheter Aortic Valve Replacement Frontiers in Cardiovascular Medicine transcatheter aortic valve replacement left bundle branch block cardiac remodeling prognosis aortic stenosis |
| title | Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_full | Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_fullStr | Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_full_unstemmed | Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_short | Impact of New-Onset Persistent Left Bundle Branch Block on Reverse Cardiac Remodeling and Clinical Outcomes After Transcatheter Aortic Valve Replacement |
| title_sort | impact of new onset persistent left bundle branch block on reverse cardiac remodeling and clinical outcomes after transcatheter aortic valve replacement |
| topic | transcatheter aortic valve replacement left bundle branch block cardiac remodeling prognosis aortic stenosis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.893878/full |
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