Background
Methods
Patient selection
Matching
Electrocardiographic data
CMR protocol
CMR analysis
Statistical analysis
Results
nQRS (n = 24) | LBBB-T (n = 24) |
P value | |
---|---|---|---|
Demographic details | |||
Age, years | 80.5 ± 6.2 | 79.6 ± 9.6 | 0.670 |
Gender, male | 13 (54) | 13 (54) | 1 |
Body surface area, m2
| 1.82 ± 0.29 | 1.86 ± 0.19 | 0.332 |
Clinical details | |||
STS PROM, % | 4.5 ± 2.4 | 5.1 ± 2.8 | 0.397 |
STS Morbidity/mortality, % | 21.7 ± 7.5 | 24.5 ± 8.8 | 0.452 |
Systolic blood pressure, mmHg | 134 ± 25.9 | 138 ± 18 | 0.558 |
Hypertension | 12 (57.1) | 9 (37.5) | 0.383 |
Cerebrovascular disease | 4 (16.7) | 4 (16.7) | 1 |
Previous myocardial infarction | 5 (20.8) | 2 (8.3) | 0.220 |
Chronic obstructive pulmonary disease | 6 (25) | 5 (20.8) | 0.731 |
Peripheral vascular disease | 6 (25) | 7 (29.2) | 0.745 |
Diabetes mellitus | 4 (16.7) | 8 (33.3) | 0.182 |
Any epicardial coronary stenosis >50% | 9 (37.5) | 13 (54.2) | 0.247 |
Procedural details | |||
Medtronic CoreValve | 17 (71) | 17 (71) | 1 |
Pre-implant valvuloplasty | 22 (92) | 21 (88) | 0.637 |
Post-implant valvuloplasty | 6 (25) | 6 (25) | 1 |
Femoral access site | 20 (83) | 23 (96) | 0.331 |
CMR data | |||
Fibrosis mass, g | 3.3 ± 5.7 | 1.6 ± 3.8 | 0.081 |
Electrocardiographic characteristics
Reverse remodeling according to post-procedure QRS duration
nQRS (n = 24) | LBBB-T (n = 24) |
P Value | |
---|---|---|---|
Left ventricular ejection fraction | |||
Pre-procedure | 54.1 ± 11.5 | 56.6 ± 10.5 | 0.386 |
Post-procedure | 58.7 ± 9.0 | 54.4 ± 9.3 | 0.070 |
P Value | 0.010 | 0.092 | |
Global longitudinal strain, % | |||
Pre-procedure | −15.6 ± 3.9 | −16.2 ± 4.2 | 0.638 |
Post-procedure | −17.7 ± 2.7 | −15.9 ± 3.4 | 0.053 |
P Value | 0.009 | 0.771 | |
Indexed left ventricular mass, g/m2
| |||
Pre-intervention | 74.3 ± 14.7 | 73.3 ± 17.4 | 0.650 |
Post-intervention | 58.4 ± 12.6 | 60.0 ± 13.7 | 0.665 |
P Value | <0.001 | <0.001 | |
Indexed left ventricular end diastolic volume, ml/m2
| |||
Pre-intervention | 97.8 ± 22.8 | 93.4 ± 22.1 | 0.500 |
Post-intervention | 90.5 ± 21.0 | 90.3 ± 21.0 | 0.968 |
P Value | 0.051 | 0.298 | |
Indexed left ventricular end systolic volume, ml/m2
| |||
Pre-intervention | 46.6 ± 20.4 | 41.8 ± 17.7 | 0.458 |
Post-intervention | 38.7 ± 16.2 | 42.4 ± 17.8 | 0.523 |
P Value | 0.011 | 0.886 | |
Indexed left ventricular stroke volume, ml/m2
| |||
Pre-intervention | 51.2 ± 10.3 | 51.4 ± 10.5 | 0.945 |
Post-intervention | 51.8 ± 8.7 | 47.9 ± 8.5 | 0.122 |
P Value | 0.742 | 0.035 | |
Indexed left atrial volume, ml/m2
| |||
Pre-intervention | 67.9 ± 19.2 | 72.9 ± 23.3 | 0.232 |
Post-intervention | 60.0 ± 18.2 | 67.9 ± 23.8 | 0.199 |
P Value | 0.002 | 0.180 |
Inter- and intra-ventricular dyssynchrony
Predictors of change in LVEF and change in GLS
Coefficient B | Standard Error |
P Value | Coefficient B | Standard error | P Value | |
---|---|---|---|---|---|---|
Univariate analysis – change in LVEF | Multiple regression analysis – change in LVEF | |||||
Age | −0.201 | 0.141 | 0.160 | |||
Sex | 2.844 | 2.246 | 0.212 | |||
Diabetes mellitus | −1.092 | 2.624 | 0.679 | |||
Infarct pattern LGE at baseline | 1.647 | 2.819 | 0.562 | |||
STS PROM | −0.020 | 0.448 | 0.965 | |||
Post-procedure QRS duration | −0.119 | 0.034 | 0.001 | −0.110 | 0.028 | <0.001 |
AVAi | 7.888 | 14.638 | 0.593 | |||
Baseline GLS | −0.963 | 0.249 | <0.001 | −0.292 | 0.319 | 0.365 |
Baseline LVEF | −0.393 | 0.088 | <0.001 | −0.295 | 0.117 | 0.015 |
Baseline fibrosis mass | −0.007 | 0.242 | 0.975 | |||
Post procedure aortic regurgitation fraction | 0.089 | 0.252 | 0.725 | |||
Univariate analysis – change in GLS | Multiple regression analysis – change in GLS | |||||
Age | 0.090 | 0.064 | 0.167 | |||
Sex | −1.161 | 1.028 | 0.265 | |||
Diabetes mellitus | −0.467 | 1.197 | 0.698 | |||
Infarct pattern LGE at baseline | −0.078 | 1.291 | 0.952 | |||
STS PROM | −0.108 | 0.204 | 0.600 | |||
Post-procedure QRS duration | 0.044 | 0.016 | 0.010 | 0.038 | 0.011 | 0.001 |
AVAi | −4.954 | 6.658 | 0.461 | |||
Baseline GLS | −0.588 | 0.098 | <0.001 | −0.904 | 0.122 | <0.001 |
Baseline LVEF | 0.094 | 0.046 | 0.046 | −0.163 | 0.044 | 0.001 |
Post-procedure aortic regurgitation fraction | −0.015 | 0.116 | 0.895 | |||
Baseline fibrosis mass | −0.004 | 0.112 | 0.970 |