Prognostic value of pre-procedural left ventricular strain for clinical events after transcatheter aortic valve implantation

Noriko Suzuki-Eguchi, Mitsushige Murata, Yuji Itabashi, Kosuke Shirakawa, Memori Fukuda, Jin Endo, Hikaru Tsuruta, Takahide Arai, Kentaro Hayashida, Hideyuki Shimizu, Keiichi Fukuda

Research output: Contribution to journalArticle

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Abstract

Background Transcatheter aortic valve implantation (TAVI) is an alternative therapy for surgically highrisk patients with severe aortic stenosis (AS). Although TAVI improves survival of patients with severe AS, the mechanism of this effect remains to be clarified. We investigated the effects of TAVI on left ventricular (LV) function and identified the predictive parameters for cardiac events after TAVI. Methods and results We studied 128 patients with severe symptomatic AS who underwent TAVI. Echocardiographic assessments were performed before and after TAVI. In addition to the conventional echocardiographic parameters such as LV ejection fraction (LVEF) and LV mass index (LVMI), the LV global longitudinal strain (GLS) and early diastolic peak strain rate (SR-E) using two-dimensional speckle tracking echocardiography were also evaluated. All patients were assessed for clinical events including major adverse cardiac events and stroke according to Valve Academic Research Consortium-2 criteria. GLS, early diastolic peak velocity (e'), aortic regurgitation (AR) severity, and SR-E were significantly improved after TAVI. Thirteen patients had an event during the observational period of 591 days (median). Patients with events had higher LVMI, more severe AR, and worse GLS compared to those without events. Furthermore, receiver-operating curve analysis revealed that GLS was the strongest predictor for clinical events (p = 0.009; area under the curve, 0.73). Conclusion Preoperative LV geometric deformation and dysfunction, as a consequence of the cumulative burden of pressure overload, improved after TAVI and could predict cardiac events after TAVI.

Original languageEnglish
Article numbere0205190
JournalPLoS One
Volume13
Issue number10
DOIs
Publication statusPublished - 2018 Oct 1

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Strain rate
Aortic Valve Stenosis
Echocardiography
Aortic Valve Insufficiency
Speckle
alternative medicine
echocardiography
stroke
Transcatheter Aortic Valve Replacement
Complementary Therapies
Left Ventricular Function
Stroke Volume
Area Under Curve
Stroke
Pressure
Survival
Research
methodology

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Prognostic value of pre-procedural left ventricular strain for clinical events after transcatheter aortic valve implantation. / Suzuki-Eguchi, Noriko; Murata, Mitsushige; Itabashi, Yuji; Shirakawa, Kosuke; Fukuda, Memori; Endo, Jin; Tsuruta, Hikaru; Arai, Takahide; Hayashida, Kentaro; Shimizu, Hideyuki; Fukuda, Keiichi.

In: PLoS One, Vol. 13, No. 10, e0205190, 01.10.2018.

Research output: Contribution to journalArticle

Suzuki-Eguchi, Noriko ; Murata, Mitsushige ; Itabashi, Yuji ; Shirakawa, Kosuke ; Fukuda, Memori ; Endo, Jin ; Tsuruta, Hikaru ; Arai, Takahide ; Hayashida, Kentaro ; Shimizu, Hideyuki ; Fukuda, Keiichi. / Prognostic value of pre-procedural left ventricular strain for clinical events after transcatheter aortic valve implantation. In: PLoS One. 2018 ; Vol. 13, No. 10.
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