Does TAVR improve left ventricular and left atrial mechanics in patients with symptomatic severe aortic stenosis?
TAVR induces early reverse left ventricular and left atrial remodeling as measured by strain imaging, even in the absence of changes in LVEF.
Background. Measures of adverse cardiac remodeling, left ventricular global longitudinal strain (LVGLS) and left atrial (LA) phasic function, are predictive of cardiac events in patients with severe aortic stenosis (AS). How these parameters of cardiac function change following TAVR requires further investigation. Methods. A number of 109 consecutive patients with symptomatic severe AS who were seen in the heart valve clinic between 2014 and 2019 for TAVR were included. All patients underwent echocardiographic assessment prior to and 30 days following TAVR, with LVGLS and LA phasic function evaluation using 2D speckle-tracking echocardiography. Heart failure hospitalization, and death were assessed at 12 months. Results. The mean age of the study cohort was 81 ± 7.3 years. Following TAVR, there was a significant reduction in NYHA class III/IV symptoms 89 (82%) vs. 12 (11%), p p p = 0.2; however, the LVGLS significantly increased following TAVR [15 ± 3.5% vs. 18 ± 3.3%, p p p p Conclusions. TAVR results in significant short-term reverse LV and LA remodeling, as shown by improvement in LV GLS and all three components of LA phasic function, despite no change in the LVEF. The findings indicate the possible utility of strain imaging for the assessment of global LV and LA function following TAVR.
Anastasius et al. (Fri,) studied this question.