Left Ventricular Functional Recovery and Remodeling in Low-Flow Low-Gradient Severe Aortic Stenosis after Transcatheter Aortic Valve Implantation - 30/07/14
Abstract |
Background |
Speckle-tracking-derived global longitudinal strain (GLS) is a more sensitive method of detecting left ventricular (LV) functional recovery after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis. However, it remains unknown whether LV function improves in patients with low-flow, low-gradient severe aortic stenosis (LFLGSAS) after TAVI. The aim of the present was to evaluate LV functional recovery and remodeling after TAVI in patients with LFLGSAS.
Methods |
Sixty-eight patients (57% men; mean age, 79.1 ± 7.1 years) with LFLGSAS treated with TAVI were evaluated. LV function and remodeling were investigated before TAVI and at 6 and 12 months after TAVI. All echocardiographic data were prospectively collected, and GLS was retrospectively analyzed.
Results |
Among patients with LFLGSAS, 35 (52%) had low LV ejection fraction (LVEF) (<50%), and 33 (48%) had preserved LVEF (≥50%). The low-LVEF group had significantly more impaired GLS than the group with preserved LVEF (−8.3 ± 2.6% vs −13.3 ± 3.5%, P < .001). LV systolic function improved after TAVI in both groups. Although in the group of patients with low LVEF, all functional parameters improved, in the group of patients with preserved LVEF, only strain-derived parameters significantly improved. There were significant decreases in absolute LV wall thickness and relative wall thickness and a trend toward decreased LV mass index in both LVEF groups. LV volumes decreased significantly in those with low LVEF but not in those with preserved LVEF. Baseline GLS but not LVEF group was independently associated to GLS improvement at 12 months after TAVI.
Conclusions |
Patients with LFLGSAS with low and preserved LVEF had a significant improvement in LV function after TAVI, as assessed by GLS. Absolute and relative LV wall thickness decreased in both groups of patients, but only those with low LVEF had reductions in LV volumes.
Le texte complet de cet article est disponible en PDF.Keywords : Aortic valve stenosis, Low-flow low-gradient, Speckle-tracking, Strain, Transcatheter aortic valve implantation
Abbreviations : AVA, BSA, CI, GLS, GLSr, LFLGSAS, LV, LVEF, LVMi, PARTNER
Plan
| Dr Kamperidis received a European Society of Cardiology training grant and a Hellenic Cardiological Society training grant. Dr Joyce is supported by a European Society Of Cardiology training grant and a national cardiovascular educational bursary from Merck Sharp & Dohme (Whitehouse Station, NJ). Dr Debonnaire is supported by a Sadra Medical research grant (Boston Scientific Corporation, Natick, MA) and holds a European Association of Cardiovascular Imaging research grant. Dr Katsanos received a Hellenic Cardiological Society training grant. The Department of Cardiology received grants from Biotronik GmbH (Berlin, Germany), Medtronic, Boston Scientific Corporation, St. Jude Medical, Sandra Lotus, and GE Healthcare (Little Chalfont, United Kingdom). Dr Delgado received consulting fees from St. Jude Medical and Medtronic. |
Vol 27 - N° 8
P. 817-825 - août 2014 Retour au numéro
Article précédent
- Radiation Safety for the Cardiac Sonographer: Recommendations of the Radiation Safety Writing Group for the Council on Cardiovascular Sonography of the American Society of Echocardiography
- Elizabeth F. McIlwain, Patrick D. Coon, Andrew J. Einstein, Carol K.C. Mitchell, Gregory W. Natello, Richard A. Palma, Margaret M. Park, Frank Ranallo, Marsha L. Roberts
- Outcomes of Asymptomatic Adults with Combined Aortic Stenosis and Regurgitation
- Nina Rashedi, Zoran B. Popovi?, William J. Stewart, Thomas Marwick
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?