TY - JOUR
T1 - Left ventricular adaptation after TAVI evaluated by conventional and speckle-tracking echocardiography
AU - Dimitriadis, Zisis
AU - Scholtz, Smita
AU - Ensminger, Stephan
AU - Wiemer, Marcus
AU - Fischbach, Thomas
AU - Scholtz, Werner
AU - Piper, Cornelia
AU - Börgermann, Jochen
AU - Bitter, Thomas
AU - Horstkotte, Dieter
AU - Faber, Lothar
N1 - Funding Information:
The author received a research grant by the Ruhr-Universität Bochum ( K078-13 ).
Publisher Copyright:
© 2016 Elsevier Ireland Ltd
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objective Our study aimed to evaluate myocardial adaption and outcome after transfemoral aortic valve implantation (TAVI TF) for severe aortic stenosis by LV ejection fraction (LVEF) and speckle tracking analysis. Methods and results From 168 patients who underwent TAVI TF between 2010 and 2013 in our institution, n = 95 with a follow-up period ≥ 3 months were included and grouped (G) according to baseline left ventricular ejection fraction (LVEF; G1: LVEF < 40%, G2: 40%–55%, G3: > 55%). LV function was evaluated using conventional and speckle-tracking based parameters. Mortality was tracked up to 60 months. Aortic valve orifice diameter and mean aortic gradient improved significantly after TAVI. LV dimensions and LVEF remained largely unchanged. Systolic function significantly improved in G1 (LVEF, p < 0.001, global longitudinal strain [GLS], p = 0.02) but deteriorated in G3 (LVEF, p = 0.004, GLS, p = 0.03). It did not change in G2. Diastolic function parameters improved significantly only in G3. Changes of LVEF and GLS were also statistically significant between G1 and G3 (LVEF p < 0.0001, GLS p = 0.004). Patients exhibited a higher survival rate with an LVEF increase > 8% than with LVEF deterioration > 8% (p = 0.04). GLS changes had no significant impact on mortality. Conclusion In patient with aortic stenosis and LVEF impairment at baseline, TAVI results in an improved LVEF, while patients with a high LVEF at baseline experience a normalization of LVEF after TAVI. Independent of the baseline value, a deterioration of LVEF leads to a significant increase in mortality.
AB - Objective Our study aimed to evaluate myocardial adaption and outcome after transfemoral aortic valve implantation (TAVI TF) for severe aortic stenosis by LV ejection fraction (LVEF) and speckle tracking analysis. Methods and results From 168 patients who underwent TAVI TF between 2010 and 2013 in our institution, n = 95 with a follow-up period ≥ 3 months were included and grouped (G) according to baseline left ventricular ejection fraction (LVEF; G1: LVEF < 40%, G2: 40%–55%, G3: > 55%). LV function was evaluated using conventional and speckle-tracking based parameters. Mortality was tracked up to 60 months. Aortic valve orifice diameter and mean aortic gradient improved significantly after TAVI. LV dimensions and LVEF remained largely unchanged. Systolic function significantly improved in G1 (LVEF, p < 0.001, global longitudinal strain [GLS], p = 0.02) but deteriorated in G3 (LVEF, p = 0.004, GLS, p = 0.03). It did not change in G2. Diastolic function parameters improved significantly only in G3. Changes of LVEF and GLS were also statistically significant between G1 and G3 (LVEF p < 0.0001, GLS p = 0.004). Patients exhibited a higher survival rate with an LVEF increase > 8% than with LVEF deterioration > 8% (p = 0.04). GLS changes had no significant impact on mortality. Conclusion In patient with aortic stenosis and LVEF impairment at baseline, TAVI results in an improved LVEF, while patients with a high LVEF at baseline experience a normalization of LVEF after TAVI. Independent of the baseline value, a deterioration of LVEF leads to a significant increase in mortality.
UR - http://www.scopus.com/inward/record.url?scp=84995932318&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2016.11.035
DO - 10.1016/j.ijcard.2016.11.035
M3 - Journal articles
C2 - 27883973
AN - SCOPUS:84995932318
SN - 0167-5273
VL - 228
SP - 633
EP - 637
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -