A1 Refereed original research article in a scientific journal
Changes in Computed-Tomography-Derived Segmental Left Ventricular Longitudinal Strain After Transcatheter Aortic Valve Implantation
Authors: Singh Gurpreet K, Fortuni Federico, Kuneman Jurrien H, Vollema E Mara, van der Kley Frank, Marsan Nina A, Delgado Victoria, Bax Jeroen J
Publisher: Elsevier
Publication year: 2023
Journal: American Journal of Cardiology
Journal name in source: The American journal of cardiology
Journal acronym: Am J Cardiol
Volume: 198
First page : 95
Last page: 100
ISSN: 0002-9149
eISSN: 1879-1913
DOI: https://doi.org/10.1016/j.amjcard.2023.04.021
Web address : https://doi.org/10.1016/j.amjcard.2023.04.021
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/179829674
Patients with severe aortic stenosis (AS) may show left ventricular (LV) apical longitudinal strain sparing. Transcatheter aortic valve implantation (TAVI) improves LV systolic function in patients with severe AS. However, the changes in regional longitudinal strain after TAVI have not been extensively evaluated. This study aimed to characterize the effect of the pressure overload relief after TAVI on LV apical longitudinal strain sparing. A total of 156 patients (mean age 80 ± 7 years, 53% men) with severe AS who underwent computed tomography before and within 1 year after TAVI (mean time to follow-up 50 ± 30 days) were included. LV global and segmental longitudinal strain were assessed using feature tracking computed tomography. LV apical longitudinal strain sparing was evaluated as the ratio between the apical and midbasal longitudinal strain and was defined as an LV apical to midbasal longitudinal strain ratio >1. LV apical longitudinal strain remained stable after TAVI (from 19.5 ± 7.2% to 18.7 ± 7.7%, p = 0.20), whereas LV midbasal longitudinal strain showed a significant increase (from 12.9 ± 4.2% to 14.2 ± 4.0%, p ≤0.001). Before TAVI, 88% of the patients presented with LV apical strain ratio >1% and 19% presented with an LV apical strain ratio >2. After TAVI, these percentages significantly decreased to 77% and 5% (p = 0.009, p ≤0.001), respectively. In conclusion, LV apical sparing of strain is a relatively common finding in patients with severe AS who underwent TAVI and its prevalence decreases after the afterload relief after TAVI.
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