Author + information
- Niraj Asthana,
- Aditya Mantha,
- Eric Yang,
- Peyman Benharash and
- Gabriel Vorobiof
Background: Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of severe aortic valve stenosis in patients at high surgical risk. Speckle tracking echocardiography (STE) is a novel, load- and angle-independent technique for the assessment of left ventricular (LV) function via myocardial strain. We hypothesized that systolic and diastolic function, as assessed by STE, would show improvement post-TAVR prior to traditional techniques.
Methods: Phillips QLAB software (version 10.4) was used to analyze echocardiograms of all patients with severe aortic valve stenosis that underwent TAVR at Ronald Reagan UCLA Medical Center from 2012-2016. Parameters that were assessed include (i) Traditional measures of systolic & diastolic function: left ventricular ejection fraction (LVEF), E- and A-wave, tissue Doppler annular velocity (e') (ii) Left ventricular global longitudinal strain (GLS) and circumferential strain (GCS) and strain rates measured by two-dimensional STE. Echocardiograms were evaluated pre-TAVR (mean: 20.1 d), post-operatively (mean: 2.5 d), and at 1 month (mean: 32.7 d). Statistical analysis was performed using a multi-level generalized linear mixed model.
Results: Of the 216 patients assessed (51% male, 84.08 +/- 11.49 years in age), 171 patients had echo data compatible with STE software (458 studies). Compared to the pre-TAVR baseline, at the 1-month follow-up: (i) GLS improved from −15.8 +/- 6.2% to 17.8 +/- 6.2% (p < .0001) (ii) GCS did not significantly change (from −17.4 +/- 8.2% to −21.4 +/- 8.68% with p > .05) and (iii) Global diastolic longitudinal strain rate improved from .88 +/- .29 1/s to 1.02 +/- .33 1/s (p < .05). However, traditional measures of myocardial systolic function (LVEF) and diastolic function (E, A, e', E/A, E/e') did not significantly change post-TAVR over the same time frame (p > .05).
Conclusions: Both systolic and diastolic LV function, as measured by myocardial strain and strain rates via STE, improve early post-TAVR. Moreover, STE-derived parameters appear to be more sensitive than traditional echocardiographic measures of LV function post-TAVR.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: New Technologies in Echocardiography
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1245-217
- 2017 American College of Cardiology Foundation