Refereed review article in scientific journal (A2)
Prognostic Value of Preprocedural LV Global Longitudinal Strain for Post-TAVR-Related Morbidity and Mortality: A Meta-Analysis
List of Authors: Stens Niels A, van Iersel Odette, Rooijakkers Max JP, van Wely Marleen H, Nijveldt Robin, Bakker Esmee A, Rodwell Laura, Pedersen Anders LD, Poulsen Steen H, Kjønås Didrik, Stassen Jan, Bax Jeroen J, Tanner Felix C, Lerakis Stamatios, Shimoni Sara, Poulin Frederic, Ferreira Vera, Reskovic Luksic Vlatka, van Royen Niels, Thijssen Dick HJ
Publication year: 2023
Journal: JACC: Cardiovascular Imaging
Journal name in source: JACC. Cardiovascular imaging
Journal acronym: JACC Cardiovasc Imaging
Volume number: 16
Issue number: 3
Start page: 332
End page: 341
ISSN: 1876-7591
eISSN: 1876-7591
DOI: http://dx.doi.org/10.1016/j.jcmg.2023.01.005
URL: https://www.sciencedirect.com/science/article/pii/S1936878X23000360?via%3Dihub
Background
Left ventricular ejection fraction (LVEF) demonstrates limited prognostic value for post-transcatheter aortic valve replacement (TAVR) outcomes. Evidence regarding the potential role of left ventricular global longitudinal strain (LV-GLS) in this setting is inconsistent.
Objectives
The aim of this systematic review and meta-analysis of aggregated data was to evaluate the prognostic value of preprocedural LV-GLS for post–TAVR-related morbidity and mortality.
Methods
The authors searched PubMed, Embase, and Web of Science for studies investigating the association between preprocedural 2-dimensional speckle-tracking–derived LV-GLS and post-TAVR clinical outcomes. An inversely weighted random effects meta-analysis was adopted to investigate the association between LV-GLS vs primary (ie, all-cause mortality) and secondary (ie, major cardiovascular events [MACE]) post-TAVR outcomes.
Results
Of the 1,130 identified records, 12 were eligible, all of which had a low-to-moderate risk of bias (Newcastle-Ottawa scale). On average, 2,049 patients demonstrated preserved LVEF (52.6% ± 1.7%), but impaired LV-GLS (−13.6% ± 0.6%). Patients with a lower LV-GLS had a higher all-cause mortality (pooled HR: 2.01; 95% CI: 1.59-2.55) and MACE (pooled odds ratio [OR]: 1.26; 95% CI: 1.08-1.47) risk compared with patients with higher LV-GLS. In addition, each percentage point decrease of LV-GLS (ie, toward 0%) was associated with an increased mortality (HR: 1.06; 95% CI: 1.04-1.08) and MACE risk (OR: 1.08; 95% CI: 1.01-1.15).
Conclusions
Preprocedural LV-GLS was significantly associated with post-TAVR morbidity and mortality. This suggests a potential clinically important role of pre-TAVR evaluation of LV-GLS for risk stratification of patients with severe aortic stenosis. (Prognostic value of left ventricular global longitudinal strain in patients with aortic stenosis undergoing Transcatheter Aortic Valve Implantation: a meta-analysis; CRD42021289626)