The effect of transcatheter aortic valve implantation on Tp-e interval, Tp-e/QT and Tp-e/QTc ratios, and Tp-e dispersion in patients with severe aortic stenosis

Background: In this study, we aimed to investigate the effect of transcatheter aortic valve implantation using two types of bioprosthetic valves on novel ventricular repolarization markers including Tp-e, Tp-e/QT and Tpe/QTc ratios, and Tp-ed. Methods: A total of 61 patients (17 males, 44 females; mean age 78.6±6.5 years; range 55 to 89 years) who underwent transcatheter aortic valve implantation with either a Medtronic CoreValve (n=40) or an Edwards SAPIEN XT valve (n=21) were retrospectively analyzed. The electrocardiographic parameters and left ventricular mass index were calculated prior to the procedure, on postoperative Day 1, and at three months after the procedure. Results: The Tp-e interval, Tp-e/QT and Tp-e/QTc ratios, Tp-ed, and left ventricular mass index significantly reduced at three months of the procedure, compared to baseline values (p<0.01, for all). Similar findings were observed for QT, QTc, and QT dispersion (p<0.01, for all). These changes were independent from the types of bioprosthetic valves used. Before the procedure, the left ventricular mass index was positively correlated with the Tp-e (r=0.350, p=0.007), Tp-e/QT (r=0.314, p=0.015) and Tp-e/QTc ratios (r=0.285, p=0.029). In the multivariate analysis, Tp-e interval was found to be independently associated with the left ventricular mass index (b=0.350, p=0.007). Conclusion: In the present study, the Tp-e interval, Tp-e/QT and Tp-e/QTc ratios, Tp-ed, and left ventricular mass index significantly reduced at three months after transcatheter aortic valve implantation indicating reverse left ventricular remodeling. The effects of two types of bioprosthetic valves on ventricular repolarization markers and left ventricular mass index were similar.