Left ventricular speckle tracking echocardiographic evaluation before and after TAVI

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Transcatheter aortic valve implantation (TAVI) is a key treatment for severe aortic stenosis.
• Assessing left ventricular (LV) function post-TAVI is crucial for understanding outcomes.
• Global longitudinal strain (GLS) offers a sensitive measure of LV function beyond ejection fraction (EF).

Purpose of the Study:

• To evaluate changes in LV function using conventional echocardiography and GLS after TAVI.
• To compare the effectiveness of Edwards S3 and Evolut R valves on LV function and remodeling.
• To identify predictors of LV functional improvement post-TAVI.

Main Methods:

• Retrospective analysis of 85 patients undergoing TAVI between 2015-2018.
• Exclusion of patients with coronary artery disease or atrial fibrillation.
• Assessment of LV function via conventional echocardiographic parameters and GLS pre- and post-TAVI.

Main Results:

• TAVI led to significant early improvement in GLS (P=0.01) but not EF (P=0.09).
• LV mass decreased, particularly in patients with baseline LV hypertrophy (P < 0.001).
• No significant differences in LV function improvement or remodeling were observed between Edwards S3 and Evolut R valves (P=0.14).

Conclusions:

• TAVI promotes reverse remodeling and enhances GLS, especially in patients with impaired baseline LV function.
• Both Edwards S3 and Evolut R valves yield comparable improvements in LV function post-TAVI.
• A higher incidence of aortic regurgitation was noted with the Evolut R valve compared to the Edwards S3.