Distribution and prognostic value of left ventricular global longitudinal strain in elderly patients with symptomatic severe aortic stenosis undergoing transcatheter aortic valve replacement

• Published in: BMC cardiovascular disorders 2020-12, Vol.20 (1), p.506-506, Article 506
• Main Authors: Povlsen, Jonas Agerlund, Rasmussen, Vibeke Guldbrand, Vase, Henrik, Jensen, Kaare Troels, Terkelsen, Christian Juhl, Christiansen, Evald Høj, Tang, Mariann, Pedersen, Anders Lehmann Dahl, Poulsen, Steen Hvitfeldt
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged patients; Aged, 80 and over; Aortic stenosis; Aortic valve; Aortic valve stenosis; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - mortality; Aortic Valve Stenosis - physiopathology; Aortic Valve Stenosis - surgery; Asymptomatic; Care and treatment; Comorbidity; Denmark; Echocardiography; Female; Global longitudinal strain; Health aspects; Heart; Heart attacks; Heart valve replacement; Humans; Left ventricular function; Male; Mortality; Multivariate analysis; Myocardial infarction; Patient outcomes; Population; Prevalence; Prognosis; Recovery of Function; Retrospective Studies; Risk Assessment; Risk Factors; Sensitivity analysis; Severity of Illness Index; Stenosis; Stroke Volume; Survival; Survival analysis; TAVR; Time Factors; Transcatheter Aortic Valve Replacement - adverse effects; Transcatheter Aortic Valve Replacement - mortality; Treatment Outcome; Variables; Velocity; Ventricle; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-020-01791-9

The aim of present study was to examine the preoperative prevalence and distribution of impaired left ventricular global longitudinal strain (LVGLS) in elderly patients with symptomatic aortic stenosis (AS) undergoing transcutaneous aortic valve replacement (TAVR) and to determine the predictive value of LVGLS on survival. We included 411 patients with symptomatic severe AS treated with TAVR during a 5-year period, where a baseline echocardiography including LVGLS assessment was available. Mean age was 80.1 ± 7.1 years and aortic valve area (AVA) index 0.4 ± 0.1 cm . 78 patients died during a median follow-up of 762 days. Mean left ventricular ejection fraction (LVEF) was 50 ± 13% and mean LVGLS was - 14.0%. LVEF was preserved in 60% of patients, while impaired LVGLS > - 18% was seen in 75% of the patients. Previous myocardial infarction, LVEF  - 14%, low gradient AS ( 30 mmHg were identified as significant univariate predictors of all-cause mortality. On multivariate analysis LVGLS > - 14% (HR 1.79 [1.02-3.14], p = 0.04) was identified as the only independent variable associated with all-cause mortality. Reduced survival was observed with an impaired LVGLS > - 14% in the total population (p  - 14% was an independent predictor of all-cause mortality, and survival was reduced if LVGLS > - 14%.