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Updated: Jan 4, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

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Subclinical leaflet thrombosis is associated with impaired reverse remodelling after transcatheter aortic valve

Bálint Szilveszter1, Daniel Oren1, Levente Molnár1

  • 1MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Városmajor Street, 1122 Budapest, Hungary.

European Heart Journal. Cardiovascular Imaging
|October 31, 2019
PubMed

Insights

Transcatheter aortic valve implantation (TAVI) significantly reduces left ventricular mass, promoting reverse remodelling. Subclinical leaflet thrombosis may impede these beneficial changes, but reverse remodelling is linked to better long-term outcomes.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Cardiac CT is crucial for planning and monitoring transcatheter aortic valve implantation (TAVI).
  • Limited data exist on reverse remodelling post-TAVI assessed by CT.
  • Understanding predictors and prognostic value of LV reverse remodelling is essential.

Purpose of the Study:

  • To evaluate predictors of left ventricular (LV) reverse remodelling after TAVI using CT angiography.
  • To assess the prognostic value of LV reverse remodelling following TAVI.

Main Methods:

  • 117 patients with severe aortic stenosis underwent pre- and post-TAVI CT scans.
  • LV mass (LVM) changes were analyzed, defining reverse remodelling as >20% LVM reduction.
  • Predictors and prognostic associations were assessed using multivariable analysis.

Main Results:

  • TAVI significantly reduced LV mass (LVM) post-procedure (P < 0.001).
  • 62.4% of patients showed reverse remodelling.
  • Subclinical leaflet thrombosis (SLT), prior myocardial infarction, and increased mean pressure gradient were associated with less reverse remodelling.

Conclusions:

  • TAVI effectively induces LV reverse remodelling, measurable by CT.
  • SLT may negatively impact LV reverse remodelling.
  • LV reverse remodelling after TAVI is associated with improved long-term prognosis.
Abstract

Keywords:
CT angiographyleft ventricular reverse remodellingsubclinical leaflet thrombosistranscatheter aortic valve implantation

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