Publication: Sustained Improvement of Left Ventricular Strain following Transcatheter Aortic Valve Replacement.
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Date
2019-07-15
Authors
Lozano Granero, Vanesa Cristina
Fernández Santos, Sara
Fernández-Golfín, Covadonga
González Gómez, Ariana
Plaza Martín, María
de la Hera Galarza, Jesús María
Faletra, Francesco Fulvio
Swaans, Martin J
López-Fernández, Teresa
Mesa, Dolores
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Abstract
Left ventricular (LV) mechanics are impaired in patients with severe aortic stenosis (AS). Transcatheter aortic valve replacement (TAVR) has become a widespread technique for patients with severe AS considered inoperable or high risk for open surgery. This procedure could have a positive impact in LV mechanics. The aim of the study was to evaluate the effect of TAVR on LV function recovery, as assessed by myocardial deformation parameters, both immediately and in the long term. One-hundred nineteen consecutive patients (81.2 ± 6.9 years, 50.4% female) from 10 centres in Europe with severe AS who successfully underwent TAVR with either a self-expanding CoreValve (Medtronic, Minneapolis, MN, USA) or a mechanically expanded Lotus valve (Boston Scientific, Natick, MA, USA) were enrolled in a prospective observational study. A complete echocardiographic examination was performed prior to device implantation, before discharge and 1 year after the procedure, including the assessment of LV strain using standard 2D images. Between baseline and discharge, only a modest but statistically significant improvement in GLS (global longitudinal strain) could be seen (GLS% -14.6 ± 5.0 at baseline; -15.7 ± 5.1 at discharge, p = 0.0116), although restricted to patients in the CoreValve group; 1 year after the procedure, a greater improvement in GLS was observed (GLS% -17.1 ± 4.9, p Immediate and sustained improvement in GLS was appreciated after the TAVR procedure. Whether this finding continues to be noted in a more prolonged follow-up and its clinical implications need to be assessed in further studies.
Description
MeSH Terms
Aged, 80 and over
Aortic Valve Stenosis
Echocardiography
Female
Heart Valve Prosthesis
Heart Ventricles
Humans
Male
Prospective Studies
Transcatheter Aortic Valve Replacement
Ventricular Dysfunction, Left
Aortic Valve Stenosis
Echocardiography
Female
Heart Valve Prosthesis
Heart Ventricles
Humans
Male
Prospective Studies
Transcatheter Aortic Valve Replacement
Ventricular Dysfunction, Left
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CIE Terms
Keywords
Aortic stenosis, Echocardiography, Left ventricular mechanics, Strain, Transcatheter aortic valve replacement