Author + information
- Vasvi Singh,
- Vijay Iyer,
- Asma Mursleen,
- Rosemary Hansen,
- Stanley Fernandez and
- Saurabh Malhotra
Background: Transcatheter Aortic Valve Replacement (TAVR), a treatment of severe aortic stenosis in high-risk patients, results in afterload reduction and change in myocardial contractility. We aimed to determine the predictors of intraoperative change in myocardial contractility and its influence on cardiovascular events (CEs).
Methods: Myocardial contractility was assessed as LV global longitudinal strain (LV-GLS) on transthoracic echocardiograms, acquired before and immediately after valve deployment in 90 patients. Occurrence of CEs after TAVR was determined and consisted of death, HF hospitalization, non-fatal MI and stroke.
Results: The mean age of the population was 82 ± 7 years (56% males), with mean STS score, mean LVEF and mean aortic valve gradient of 7.7 ± 4%, 65 ± 8%, and 36 ± 14 mmHg, respectively. There was a significant improvement in LV-GLS immediately after valve deployment (figure). LV-GLS increased in 84% of the patients after TAVR (mean change −2.3 ± 2), with age being the only independent predictor of this improvement (table). Over a follow up period of 3.5 months, CEs occurred in 16% of the patients, with an increase in post TAVR LV-GLS (OR, 95% CI: 1.46, 1.02–2.08, p=0.037) and non-white race (OR, 95% CI: 0.06, 0.01–0.56, p=0.014) as the only independent predictors.
Conclusions: There is a significant immediate improvement in LV-GLS after TAVR. Immediate intraoperative improvement in myocardial contractility as assessed by improvement LV-GLS is predictive of short-term outcomes.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Interventional Cardiology: TAVR 1
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1114-161
- 2017 American College of Cardiology Foundation