Key result
Impaired LV GLS linked to ~79% higher mortality in elderly severe AS patients undergoing TAVR.
Why the study?
The preoperative prevalence and distribution of impaired LVGLS and its predictive value on survival in elderly patients with symptomatic AS undergoing TAVR needed evaluation.
Does baseline impaired left ventricular global longitudinal strain (LVGLS > -14%) predict all-cause mortality in elderly patients with symptomatic severe aortic stenosis undergoing TAVR?
Cohort (n=411)
No
Does baseline impaired left ventricular global longitudinal strain (LVGLS > -14%) predict all-cause mortality in elderly patients with symptomatic severe aortic stenosis undergoing TAVR?
Effect estimate: HR 1.79 (95% CI 1.02-3.14)
p-value: p=0.04
In elderly patients undergoing TAVR for symptomatic severe aortic stenosis, impaired baseline LVGLS (> -14%) is highly prevalent despite preserved LVEF and serves as an independent predictor of all-cause mortality.
Impaired LVGLS may flag higher-risk TAVR patients despite preserved LVEF; hypothesis-generating and requires prospective validation before guiding care.
AIMS: The aim of present study was to examine the preoperative prevalence and distribution of impaired left ventricular global longitudinal strain (LVGLS) in elderly patients with symptomatic aortic stenosis (AS) undergoing transcutaneous aortic valve replacement (TAVR) and to determine the predictive value of LVGLS on survival. METHODS: We included 411 patients with symptomatic severe AS treated with TAVR during a 5-year period, where a baseline echocardiography including LVGLS assessment was available. RESULTS: 19.9, p = 0.006). CONCLUSIONS: In patients with symptomatic AS undergoing TAVR, impaired LVGLS was highly prevalent despite preserved LVEF. LVGLS > - 14% was an independent predictor of all-cause mortality, and survival was reduced if LVGLS > - 14%.
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Povlsen et al. (2020) conducted a cohort in Symptomatic severe aortic stenosis (n=411). Impaired left ventricular global longitudinal strain (> -14%) vs. Preserved LVGLS (≤ -14%) was evaluated on All-cause mortality (HR 1.79, 95% CI 1.02-3.14, p=0.04). Impaired left ventricular global longitudinal strain (> -14%) independently predicted all-cause mortality (HR 1.79) in elderly patients with symptomatic severe aortic stenosis undergoing TAVR.
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