Prognostic implications of impaired longitudinal left ventricular systolic function assessed by tissue Doppler imaging prior to transcatheter aortic valve implantation ... View Full Text


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Article Info

DATE

2022-01-10

AUTHORS

Guglielmo Gallone, Francesco Bruno, Teresa Trenkwalder, Fabrizio D’Ascenzo, Fabian Islas, Pier Pasquale Leone, Philipp Nicol, Costanza Pellegrini, Enrico Incaminato, Pilar Jimenez-Quevedo, Hector Alfonso Alvarez-Covarrubias, Renato Bragato, Alessandro Andreis, Stefano Salizzoni, Mauro Rinaldi, Adnan Kastrati, Federico Conrotto, Michael Joner, Giulio Stefanini, Luis Nombela-Franco, Erion Xhepa, Javier Escaned, Gaetano M. De Ferrari

ABSTRACT

Change in longitudinal left ventricular (LV) systolic function serves as an early marker of the deleterious effect of aortic stenosis (AS) and other cardiac comorbidities on cardiac function. We explored the prognostic value of tissue Doppler imaging (TDI)-derived longitudinal LV systolic function, defined by the peak systolic average of lateral and septal mitral annular velocities (average S’) among symptomatic patients with severe AS undergoing transcatheter aortic valve implantation (TAVI). 297 consecutive patients with severe AS undergoing TAVI at three european centers with available average S’ at preprocedural echocardiography were retrospectively included. The primary endpoint was the Kaplan Meier estimate of all-cause mortality. After a median 18 months (IQR 12–18) follow-up, 36 (12.1%) patients had died. Average S’ was associated with all-cause mortality (per 1 cm/sec decrease: HR 1.29, 95%CI 1.03–1.60, p = 0.025), the cut-off of 6.5 cm/sec being the most accurate. Patients with average S’ < 6.5 cm/sec (55.2%) presented characteristics of more advanced LV remodeling and functional impairment along with higher burden of cardiac comorbidities, and experienced higher all-cause mortality (17.6% vs. 7.5%, p = 0.007), also when adjusted for in-study outcome predictors (adj-HR: 2.69, 95%CI 1.22–5.93, p = 0.014). Results were consistent among patients with preserved ejection fraction, normal-flow AS, high-gradient AS and in those without LV hypertrophy. Longitudinal LV systolic function assessed by average S’ is independently associated with long-term all-cause mortality among TAVI patients. An average S’ below 6.5 cm/sec best defines clinically meaningful reduced longitudinal systolic function and may aid clinical risk stratification in these patients. More... »

PAGES

1317-1328

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10554-021-02519-2

DOI

http://dx.doi.org/10.1007/s10554-021-02519-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1144551092

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35006473


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    "description": "Change in longitudinal left ventricular (LV) systolic function serves as an early marker of the deleterious effect of aortic stenosis (AS) and other cardiac comorbidities on cardiac function. We explored the prognostic value of tissue Doppler imaging (TDI)-derived longitudinal LV systolic function, defined by the peak systolic average of lateral and septal mitral annular velocities (average S\u2019) among symptomatic patients with severe AS undergoing transcatheter aortic valve implantation (TAVI). 297 consecutive patients with severe AS undergoing TAVI at three european centers with available average S\u2019 at preprocedural echocardiography were retrospectively included. The primary endpoint was the Kaplan Meier estimate of all-cause mortality. After a median 18\u00a0months (IQR 12\u201318) follow-up, 36 (12.1%) patients had died. Average S\u2019 was associated with all-cause mortality (per 1\u00a0cm/sec decrease: HR 1.29, 95%CI 1.03\u20131.60, p\u2009=\u20090.025), the cut-off of 6.5\u00a0cm/sec being the most accurate. Patients with average S\u2019\u2009<\u20096.5\u00a0cm/sec (55.2%) presented characteristics of more advanced LV remodeling and functional impairment along with higher burden of cardiac comorbidities, and experienced higher all-cause mortality (17.6% vs. 7.5%, p\u2009=\u20090.007), also when adjusted for in-study outcome predictors (adj-HR: 2.69, 95%CI 1.22\u20135.93, p\u2009=\u20090.014). Results were consistent among patients with preserved ejection fraction, normal-flow AS, high-gradient AS and in those without LV hypertrophy. Longitudinal LV systolic function assessed by average S\u2019 is independently associated with long-term all-cause mortality among TAVI patients. An average S\u2019 below 6.5\u00a0cm/sec best defines clinically meaningful reduced longitudinal systolic function and may aid clinical risk stratification in these patients.", 
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