In severe aortic stenosis patients undergoing TAVI, lower RV free wall longitudinal strain (<17%) predicted 55% higher adjusted risk of death or cardiovascular hospitalization.
Does right ventricular free wall longitudinal strain (RVFWLS) predict the composite of all-cause death and cardiovascular hospitalization in patients with severe aortic stenosis undergoing TAVI?
Right ventricular free wall longitudinal strain (RVFWLS) provides superior prognostic value over conventional RV parameters for predicting survival and cardiovascular hospitalization after TAVI.
Absolute Event Rate: 0% vs 0%
Background Previously proposed staging classification based on cardiac damage highlighted that right ventricular (RV) damage reflects the most advanced stage in patients with severe aortic stenosis. This study aimed to investigate the association between RV damage detected by RV free wall longitudinal strain (RVFWLS) and outcomes in patients with severe aortic stenosis who underwent transcatheter aortic valve implantation (TAVI). Methods A total of 768 patients with severe aortic stenosis who underwent TAVI and echocardiographic images for RV functional assessment were included from a retrospective multicenter TAVI registry. The primary outcome was a composite of all‐cause death and hospitalization due to cardiovascular events. Results During a median follow‐up of 21 (12–30) months, 213 patients (28%) experienced the primary end points. In the multivariable Cox proportional hazards model, a higher absolute RVFWLS value was independently associated with better outcomes (adjusted hazard ratio HR, 0.88 95% CI, 0.84–0.91). RVFWLS demonstrated incremental values superior to those of conventional RV parameters. Adding RVFWLS <17% as an RV damage (Stage 4) criterion in staging classification identified 272 (35%) patients in Stage 4. Patients with RVFWLS‐incorporated Stage 4 had lower event‐free survival than did those in the other stages (adjusted HR, 1.55 95% CI, 1.35–1.77). Conclusion In patients with severe aortic stenosis who underwent TAVI, RVFWLS was independently associated with outcomes and provided superior prognostic value than other conventional RV echocardiographic parameters. Incorporating RVFWLS in a staging classification for RV damage showed incremental value for predicting survival after TAVI over the original staging classification.
Albakaa et al. (Fri,) reported a other. In severe aortic stenosis patients undergoing TAVI, lower RV free wall longitudinal strain (<17%) predicted 55% higher adjusted risk of death or cardiovascular hospitalization.