PMID- 26013583
OWN - NLM
STAT- MEDLINE
DCOM- 20161219
LR  - 20161230
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Linking)
VI  - 11
IP  - 12
DP  - 2016 Mar
TI  - Myocardial injury during transfemoral transcatheter aortic valve implantation: an 
      intracoronary Doppler and cardiac magnetic resonance imaging study.
PG  - 1401-8
LID - 20140923-05 [pii]
LID - 10.4244/EIJY15M05_10 [doi]
AB  - AIMS: Myocardial injury reflected by a post-procedural increase of serum troponin 
      I (TnI) occurs frequently during transcatheter aortic valve implantation (TAVI). 
      It is potentially caused by intraprocedural hypotension, periprocedural coronary 
      microembolisation and post-procedural (para)valvular leakages (PVLs). We 
      invasively assessed coronary flow dynamics including coronary flow velocity 
      reserve (CFVR), embolic high-intensity transient signals (HITS) as well as rapid 
      pacing induced hypotension and post-procedural PVLs to determine their 
      contribution to post-procedural TnI increases. METHODS AND RESULTS: In 15 
      transfemoral TAVI patients, TnI was measured serially, and cardiac MRIs with late 
      gadolinium enhancement (LGE) were performed pre- and post-interventionally. There 
      were no significant correlations between coronary flow dynamics, CFVR and the 
      area under the curve (AUC) of TnI over 72 hours. Despite the detection of HITS in 
      all patients and during all procedural steps, there was also no correlation 
      between the amount of HITS and the AUC of TnI. However, there were positive 
      correlations between the duration of rapid pacing as well as the time of 
      subsequent blood pressure recovery and the AUC of TnI. Both LGE and more than 
      mild PVL were observed in a single case only. CONCLUSIONS: Myocardial injury 
      after TAVI appears to be related more to hypoperfusion-induced ischaemia than to 
      periprocedural microembolisation.
FAU - Kahlert, Philipp
AU  - Kahlert P
AD  - Department of Cardiology, West-German Heart and Vascular Center Essen, Essen 
      University Hospital, University Duisburg-Essen, Essen, Germany.
FAU - Al-Rashid, Fadi
AU  - Al-Rashid F
FAU - Plicht, Bjorn
AU  - Plicht B
FAU - Wild, Carolin
AU  - Wild C
FAU - Westholter, Dirk
AU  - Westholter D
FAU - Hildebrandt, Heike
AU  - Hildebrandt H
FAU - Baars, Theodor
AU  - Baars T
FAU - Neumann, Till
AU  - Neumann T
FAU - Nensa, Felix
AU  - Nensa F
FAU - Nassenstein, Kai
AU  - Nassenstein K
FAU - Wendt, Daniel
AU  - Wendt D
FAU - Thielmann, Matthias
AU  - Thielmann M
FAU - Jakob, Heinz
AU  - Jakob H
FAU - Kottenberg, Eva
AU  - Kottenberg E
FAU - Peters, Jurgen
AU  - Peters J
FAU - Erbel, Raimund
AU  - Erbel R
FAU - Heusch, Gerd
AU  - Heusch G
LA  - eng
PT  - Journal Article
PL  - France
TA  - EuroIntervention
JT  - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on 
      Interventional Cardiology of the European Society of Cardiology
JID - 101251040
RN  - 0 (Biomarkers)
RN  - 0 (Troponin I)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Aortic Valve/diagnostic imaging/physiopathology
MH  - Aortic Valve Stenosis/diagnostic imaging/physiopathology/*therapy
MH  - Biomarkers/blood
MH  - Blood Flow Velocity
MH  - Cardiac Catheterization/*adverse effects/instrumentation/methods
MH  - Cardiac Pacing, Artificial
MH  - *Coronary Circulation
MH  - *Echocardiography, Doppler
MH  - Embolism/diagnostic imaging/etiology/physiopathology
MH  - Female
MH  - Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/*adverse effects/instrumentation/methods
MH  - Humans
MH  - Hyperemia/physiopathology
MH  - Hypotension/diagnostic imaging/etiology/physiopathology
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Myocardial Ischemia/blood/*diagnostic imaging/etiology/physiopathology
MH  - Myocardial Perfusion Imaging
MH  - Predictive Value of Tests
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Troponin I/blood
EDAT- 2015/05/28 06:00
MHDA- 2016/12/20 06:00
CRDT- 2015/05/28 06:00
PHST- 2015/05/28 06:00 [entrez]
PHST- 2015/05/28 06:00 [pubmed]
PHST- 2016/12/20 06:00 [medline]
AID - 20140923-05 [pii]
AID - 10.4244/EIJY15M05_10 [doi]
PST - ppublish
SO  - EuroIntervention. 2016 Mar;11(12):1401-8. doi: 10.4244/EIJY15M05_10.