Association of Acylcarnitines With Left Ventricular Remodeling in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement

Abstract

Aortic stenosis (AS) is a progressive disease characterized by narrowing of the aortic valve, which in turn exerts a pressure load on the left ventricle (LV) and leads to reduced functional capacity, heart failure, and death. As AS worsens, maladaptive cardiomyocyte apoptosis and myocardial fibrosis result in the impairment of LV diastolic relaxation and systolic function.^1,2 Clinical symptoms ensue at a late stage, at which point aortic valve replacement becomes clinically indicated.³ Recent data suggest altered myocardial energy metabolism in patients with end-stage heart failure. Circulating long-chain acylcarnitines (LCACs), intermediates of fatty acid metabolism, are prognostic in patients with chronic systolic dysfunction.^4,5 The use of mechanical LV support alleviates metabolic derangements.^4,5 We sought to evaluate LCAC metabolism within patients with AS undergoing transcatheter aortic valve replacement (TAVR).