Evaluation of Left Ventricle Systolic Functions with 2D Strain Echocardiography After Transcatheter Aortic Valve Replacement in Patients with Severe Aortic Stenosis.

BACKGROUND: It has been suggested that there is deterioration in global left ventricular (LV) longitudinal function in patients with severe aortic valve stenosis and the decrease in LV global longitudinal strain (LV-GLS) is associated with worsening prognosis. The aim of the study is to examine left ventricular mechanical changes with LV strain imaging in addition to routine examination in patients who underwent transcatheter aortic valve replacement (TAVR).

MATERIAL AND METHODS: Fifty patients who had been scheduled for the TAVR procedure between 2016 to 2018 were enrolled. The patients were evaluated before TAVR, 1 and 6 months after the procedure. The patients' LV ejection fraction (LVEF), LV-GLS, LV mass (LVM), and LV mass index (LVMI), relative wall thickness (RWT) and left atrial volume index (LAVI) were calculated with transthoracic echocardiography. The patients' performance scores were evaluated with Kansas City Cardiomyopathy Questionnaire (KCCQ-12).

RESULTS: Twenty-six patients were female (52%), and the mean ages of patients were 75.30±12.26 years. The mean LVEF of the patients was measured at 54.04±13.48% and 58.10±11.49% and 59.36±11.85 pre-procedure, at first and 6 months, respectively. This increase in LVEF was statistically significant (p<0.001). The mean LV-GLS was measured -15.83±2.78 pre-procedure. The mean of LV-GLS were -18.73±3.49 and -19.87±4.05 at first and 6 months, respectively. Performance scores of patients significantly improved after the procedure (p<0.001). The significant decreases in LVM, LVMI, RWT, and LAVI at 6 month compared to the pre-procedural evaluation (p<0.001).

CONCLUSION: In severe aortic stenosis with deformation of left ventricular myocardial mechanics, including global longitudinal strain, a successful TAVR procedure provides a significant improvement in myocardial mechanics in early and mid-term follow-up with.