Key result
Transcatheter aortic valve implantation significantly improved mean ejection fraction estimated by 2DSTE at discharge compared to baseline (56% vs. 51%, P<0.01).
Why the study?
Does transcatheter aortic valve implantation improve myocardial deformation and ejection fraction measured by 2D speckle tracking echocardiography in patients with severe aortic stenosis?
Observational (n=24)
Does transcatheter aortic valve implantation improve myocardial deformation and ejection fraction measured by 2D speckle tracking echocardiography in patients with severe aortic stenosis?
Absolute Event Rate: 56% vs 51%
p-value: p=< 0.01
2D speckle tracking echocardiography detects early significant improvements in global and segmental left ventricular systolic function after TAVI that are missed by conventional methods.
May support 2DSTE for detecting early post-TAVI LV recovery; extends imaging applications but leaves open outcome validation in RCTs.
BACKGROUND: To assess changes in myocardial deformation and ejection fraction (EF) by two-dimensional speckle tracking echocardiography (2DSTE) after transcatheter aortic valve implantation (TAVI). METHODS: A total of 24 patients (50% males, age 78 ± 4 years) were selected for TAVI because of severe aortic stenosis. A comprehensive echocardiographic study was performed before TAVI, at discharge, and after 1-month follow-up. EF was assessed by 2D conventional echocardiography with Simpson method and by 2DSTE. Radial and circumferential strains were evaluated in six segments in the short-axis view at the level of the papillary muscles, and longitudinal strain in six segments in the four-chamber apical view, by means of 2DSTE. All studies were performed with an iE-33 echocardiography device (Philips). RESULTS: At discharge, the mean EF estimated by 2DSTE improved significantly when compared with the basal one (56 ± 7% vs. 51 ± 8%, P < 0.01), while EF by Simpson method did not change (67 ± 9% vs. 64 ± 16%, P = 0.2). At that time, global radial (21.4 ± 9% vs. 11.5 ± 7.6%, P = 0.000), circumferential (-20.7 ± 8% vs. -15.2 ± 7%, P = 0.02), and longitudinal strains (-14.8 ± 6.2% vs. -12 ± 6%, P = 0.02) improved significantly when compared with the basal one. At 1-month follow-up, global radial (20.1 ± 5.6% vs. 21.4 ± 9%, P = 0.88) and circumferential (-20 ± 8% vs. -20.7 ± 8%, P = 0.35) strains did not vary and a new significant improvement was observed in longitudinal global strain (-19.2 ± 6.5% vs. -14.8 ± 6.2%, P = 0.002). CONCLUSIONS: A new echocardiographic technique, such as 2DSTE, shows a significant early improvement in global and segmental left ventricular systolic function after TAVI, which could not be detected by conventional methods.
No takes yet. Share an insight, caveat, or question.
Delgado et al. (2012) conducted an observational in Severe aortic stenosis (n=24). Transcatheter aortic valve implantation (TAVI) vs. Baseline (pre-TAVI) was evaluated on Mean ejection fraction estimated by 2DSTE at discharge (p=< 0.01). Transcatheter aortic valve implantation significantly improved mean ejection fraction estimated by 2DSTE at discharge compared to baseline (56% vs. 51%, P<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: