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Evaluation of the Effect of Transcatheter Aortic Valve Implantation on Left Ventricular Function by 4-Dimensional
Adil Bayramo Lu1, Zeynep Uluta1, J Lide Akaycan1
1Department of Cardiology, Inonu University, Faculty of Medicine, Malatya, T��rkiye.
Insights
Transcatheter aortic valve implantation significantly improves left ventricular myocardial deformation in patients with preserved ejection fraction. Four-dimensional echocardiography effectively assesses these improvements, highlighting its value in clinical practice.
Area of Science:
- Cardiology
- Echocardiography
- Cardiac Surgery
Background:
- Transcatheter aortic valve implantation (TAVI) offers benefits for aortic stenosis patients.
- Previous studies explored TAVI's impact on left ventricular function, but 4D echocardiography's role in myocardial deformation remains understudied, particularly in preserved ejection fraction (PEF) cases.
Purpose of the Study:
- To evaluate the effect of TAVI on myocardial deformation using 4D echocardiography in patients with severe aortic stenosis and PEF.
Main Methods:
- Prospective enrollment of 60 consecutive patients undergoing TAVI for severe aortic stenosis with PEF.
- Standard 2D and 4D echocardiography performed pre-procedure and 6 months post-TAVI.
Main Results:
- Significant improvements in global longitudinal, spherical circumferential, global radial, and global area strain were observed 6 months post-TAVI.
- Global area strain and absence of diabetes mellitus were independent predictors of a 10% increase in left ventricular ejection fraction.
Conclusions:
- TAVI improves left ventricular deformation parameters in patients with PEF, as evidenced by 4D echocardiography.
- Increased utilization of 4D echocardiography in clinical practice is recommended for assessing TAVI outcomes.
Objective:
Beneficial effects of transaortic valve implantation on left ventricular hemodynamics and prognosis of patients have been demonstrated. Although left ventricular systolic and diastolic function following transaortic valve implantation procedure have been examined in previous studies, 4-dimensional echocardiographic parameters have not been extensively studied, especially in patients with preserved ejection fraction aortic stenosis. In our study, we planned to evaluate the effect of transaortic valve implantation on myocardial deformation using 4-dimensional echocardiography.
Methods:
A total of 60 consecutive patients who underwent transaortic valve implantation for severe aortic stenosis with preserved ejection fraction were prospectively enrolled in the study. Standard 2-dimensional echocardiography and 4-dimensional echocardiography were performed in all patients before and 6 months after the transaortic valve implantation procedure.
Results:
Six months after valve implantation, significant improvement was observed in global longitudinal strain (P < 0.001), spherical circumferential strain (P = 0.022), global radial strain (P = 0.008), and global area strain (P < 0.001). In the regression analysis, global area strain and absence of diabetes mellitus were determined as independent predictors to show a 10% increase in the left ventricular ejection fraction.
Conclusions:
In patients with preserved ejection fraction who underwent transaortic valve implantation, left ventricle deformation parameters have improved after 6 months, especially by using 4-dimensional echocardiography. The use of 4-dimensional echocardiography should be more common in daily practice.
