What question did this study set out to answer?

This research aims to understand the timing of changes in left atrial function and volume after TAVI for severe aortic stenosis.

April 10, 2026Open Access

Left atrial functional recovery precedes volumetric reverse remodeling after TAVI by speckle tracking echocardiography

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Severe symptomatic aortic stenosis (n=162). Intervention: Transcatheter aortic valve implantation (TAVI) vs. Pre-TAVI baseline. Primary outcome: Left atrial reservoir strain (LASr) at 1 month (p=0.023).

Key Result

Transcatheter aortic valve implantation significantly improved left atrial reservoir strain at 1 month (18.2% to 24.9%), preceding significant reductions in absolute left atrial volumes at 6 months.

Key Points

This research aims to understand the timing of changes in left atrial function and volume after TAVI for severe aortic stenosis.
Conducted a prospective observational design with 162 patients undergoing TAVI.
Echocardiography assessments performed at baseline, and 1, 6, and 12 months after TAVI.
Measured left atrial strain parameters (LASr, LAScd, LASct) and left atrial volumes.
LA strain improved significantly at 1 month post-TAVI, continuing to improve up to 12 months.
Left atrial volume index (LAVI) decreased significantly at 1 month.
Absolute left atrial volumes showed significant reduction only at 6 months post-TAVI.

Study Design

Type

Observational (n=162)

Multicenter

Structured PICO

Does TAVI improve left atrial mechanics and volume over time in patients with severe aortic stenosis?

Population

162 patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI)

Intervention

Transcatheter aortic valve implantation (TAVI)

Outcome

Changes in left atrial (LA) mechanics (LA reservoir strain, conduit strain, and pump strain) and volume (LA volumes and LA volume index) using speckle-tracking echocardiography at 1, 6, and 12 months post-proceduresurrogate

Speckle-tracking echocardiography-derived left atrial strain serves as a sensitive early marker of adaptation following TAVI, demonstrating that functional improvement precedes absolute volumetric reverse remodeling.

Main Result

Absolute Event Rate: 24.9% vs 18.2%

p-value: p=0.023

Limitations

Single-center observational design may limit generalizability
Absence of invasive hemodynamic data and specific fibrotic biomarkers
Lack of a conservative management control group
Sample size precluded subgroup analyses across different AS phenotypes

Abstract

The temporal sequence of left atrial (LA) functional and structural remodeling after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) remains inadequately characterized. We aimed to evaluate the mid-term changes in LA mechanics and volume using speckle-tracking echocardiography (STE). In this prospective observational study, 162 patients with severe AS undergoing TAVI were enrolled. Echocardiography was performed at baseline, 1, 6, and 12 months post-procedure. LA reservoir strain (LASr), conduit strain (LAScd), and pump strain (LASct) were measured by STE. LA volumes and the LA volume index (LAVI) were also assessed. LA strain parameters (LASr, LAScd, LASct) improved significantly at 1 month post-TAVI (all P < 0.05) and continued to improve through 12 months. LAVI also decreased significantly at 1 month (34.3 ± 6.6 ml/m² to 28.5 ± 5.9 ml/m², P < 0.05). However, the absolute LA volumes (LAVmax and LAVmin) showed significant reduction only at 6 months post-TAVI (P < 0.05). After TAVI, LA functional improvement, assessed by STE, occurs early and with greater magnitude than volumetric changes. While LAVI decreases promptly-likely reflecting early hemodynamic unloading-reductions in absolute LA volumes are delayed. STE-derived LA strain serves as a sensitive early marker of LA adaptation following relief of outflow obstruction.

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Cite This Study

Li et al. (Tue,) conducted a observational in Severe symptomatic aortic stenosis (n=162). Transcatheter aortic valve implantation (TAVI) vs. Pre-TAVI baseline was evaluated on Left atrial reservoir strain (LASr) at 1 month (p=0.023). Transcatheter aortic valve implantation significantly improved left atrial reservoir strain at 1 month (18.2% to 24.9%), preceding significant reductions in absolute left atrial volumes at 6 months.

synapsesocial.com/papers/69d8946e6c1944d70ce0555e https://doi.org/https://doi.org/10.1038/s41598-026-42221-8

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