Author + information
- Mohammed Al-Hijji,
- Mohamad Alkhouli,
- Fahad Alqahtani,
- Vuyisile Nkomo and
- David Holmes
Electrocardiographic (ECG) strain pattern has been linked to myocardial fibrosis, and cardiovascular morbidity and mortality in patients with hypertension. We aim to determine the differential impact of strain on baseline ECG on long-term mortality after transcatheter aortic valve replacement (TAVR).
Patients who underwent TAVR between 1/2012 to 3/2016 at Mayo Clinic were included. Patients were then divided into two groups based on the presence of left ventricular strain pattern on ECG, defined as ≥ 1 mm convex ST-segment depression with asymmetrical T wave inversion in leads V5-V6. The primary end point was all cause long-term mortality.
520 patients were screened, of whom 130 were excluded due to the presence of baseline left bundle branch block or paced rhythm. Median follow up was 1.5 years, IQR (0.9-2.7). Among the 390 included patients, 47 (12%) had strain pattern on pre-TAVR ECG. Left ventricular mass index (136 (44) vs 121 (29); P=0.008) and right ventricular systolic pressure (50 (13) vs 43 (15); P=0.02) were higher in patients with strain pattern. In a multivariate logistic regression analysis, ECG strain pattern was an independent predictor of long-term mortality (Hazard ratio 2.67, 95% CI [1.72-4.04]; P<0.001).
ECG strain is an independent predictor of long-term mortality post TAVR. Systematic strain measurements might aid in risk-stratifying patients undergoing TAVR.
Moderated Poster Contributions
Vascular Medicine and Valvular Heart Disease Moderated Poster Theater, Poster Hall, Hall A/B
Sunday, March 11, 2018, 3:45 p.m.-3:55 p.m.
Session Title: Transcatheter Aortic Valve Replacement: Refining Patient Selection
Abstract Category: 37. Valvular Heart Disease: Therapy
Presentation Number: 1271M-03
- 2018 American College of Cardiology Foundation