The Predictive Value of Left Atrial Strain Following Transcatheter Aortic Valve Implantation on Anatomical and Functional Reverse Remodeling in a Multi-Modality Study
IntroductionTranscatheter aortic valve implantation (TAVI) can improve left ventricular (LV) mechanics and survival. Data on the predictive value of left atrial (LA) strain following TAVI are scarce. We aimed to evaluate the association of LA strain measured shortly post-TAVI with functional and ana...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.841658/full |
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| author | Borbála Vattay Anikó Ilona Nagy Anikó Ilona Nagy Astrid Apor Márton Kolossváry Aristomenis Manouras Milán Vecsey-Nagy Levente Molnár Melinda Boussoussou Andrea Bartykowszki Ádám L. Jermendy Tímea Kováts Emese Zsarnóczay Emese Zsarnóczay Pál Maurovich-Horvat Pál Maurovich-Horvat Béla Merkely Bálint Szilveszter |
| author_facet | Borbála Vattay Anikó Ilona Nagy Anikó Ilona Nagy Astrid Apor Márton Kolossváry Aristomenis Manouras Milán Vecsey-Nagy Levente Molnár Melinda Boussoussou Andrea Bartykowszki Ádám L. Jermendy Tímea Kováts Emese Zsarnóczay Emese Zsarnóczay Pál Maurovich-Horvat Pál Maurovich-Horvat Béla Merkely Bálint Szilveszter |
| author_sort | Borbála Vattay |
| collection | DOAJ |
| description | IntroductionTranscatheter aortic valve implantation (TAVI) can improve left ventricular (LV) mechanics and survival. Data on the predictive value of left atrial (LA) strain following TAVI are scarce. We aimed to evaluate the association of LA strain measured shortly post-TAVI with functional and anatomical reverse remodeling of the LA and LV, and its association with mortality.MethodsWe prospectively investigated 90 patients who underwent TAVI. Transthoracic echocardiography including strain analysis was performed shortly after TAVI and repeated 6 months later. CT angiography (CTA) was performed for pre-TAVI planning and 6 months post-TAVI. Speckle tracking echocardiography was used to determine LA peak reservoir strain (LASr) and LV global longitudinal strain (LV-GL), LA volume index (LAVi) was measured by TTE. LV mass index (LVMi) was calculated using CTA images. LA reverse remodeling was based on LASr and LAVi changes, whereas LV reverse remodeling was defined as an improvement in LV-GLS or a reduction of LVMi. The association of severely reduced LASr (<20%) at baseline with changes (Δ) in LASr, LAVi, LV-GLS and LVMi were analyzed using linear regression, and Cox proportional hazard model for mortality.ResultsMean LASr and LV-GLS were 17.7 ± 8.4 and −15.3 ± 3.4% at baseline and 20.2 ± 10.2 and −16.6 ± 4.0% at follow-up (p = 0.024 and p < 0.001, respectively). Severely reduced LASr at baseline was associated with more pronounced ΔLASr (β = 5.24, p = 0.025) and LVMi reduction on follow-up (β = 5.78, p = 0.036), however, the majority of the patients had <20% LASr on follow-up (44.4%). Also, ΔLASr was associated with ΔLV-GLS (adjusted β = 2.10, p < 0.001). No significant difference in survival was found between patients with baseline severely reduced LASr (<20%) and higher LASr (≥20%) (p = 0.054).ConclusionLV reverse remodeling based on LVMi was present even in patients with severely reduced LASr following TAVI, although extensive LA damage based on LA strain was demonstrated by its limited improvement over time.Clinical Trial Registration(ClinicalTrials.gov number: NCT02826200). |
| first_indexed | 2024-12-11T05:50:14Z |
| format | Article |
| id | doaj.art-5966ad07fb6f4dd88e900d85c32c4681 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-11T05:50:14Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-5966ad07fb6f4dd88e900d85c32c46812022-12-22T01:18:50ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-04-01910.3389/fcvm.2022.841658841658The Predictive Value of Left Atrial Strain Following Transcatheter Aortic Valve Implantation on Anatomical and Functional Reverse Remodeling in a Multi-Modality StudyBorbála Vattay0Anikó Ilona Nagy1Anikó Ilona Nagy2Astrid Apor3Márton Kolossváry4Aristomenis Manouras5Milán Vecsey-Nagy6Levente Molnár7Melinda Boussoussou8Andrea Bartykowszki9Ádám L. Jermendy10Tímea Kováts11Emese Zsarnóczay12Emese Zsarnóczay13Pál Maurovich-Horvat14Pál Maurovich-Horvat15Béla Merkely16Bálint Szilveszter17Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryDepartment of Medicine, Karolinska Institute, Stockholm, SwedenHeart and Vascular Center, Semmelweis University, Budapest, HungaryCardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryDepartment of Medicine, Karolinska Institute, Stockholm, SwedenHeart and Vascular Center, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryCardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryCardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryMedical Imaging Center, Semmelweis University, Budapest, HungaryCardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryMedical Imaging Center, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryCardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, HungaryIntroductionTranscatheter aortic valve implantation (TAVI) can improve left ventricular (LV) mechanics and survival. Data on the predictive value of left atrial (LA) strain following TAVI are scarce. We aimed to evaluate the association of LA strain measured shortly post-TAVI with functional and anatomical reverse remodeling of the LA and LV, and its association with mortality.MethodsWe prospectively investigated 90 patients who underwent TAVI. Transthoracic echocardiography including strain analysis was performed shortly after TAVI and repeated 6 months later. CT angiography (CTA) was performed for pre-TAVI planning and 6 months post-TAVI. Speckle tracking echocardiography was used to determine LA peak reservoir strain (LASr) and LV global longitudinal strain (LV-GL), LA volume index (LAVi) was measured by TTE. LV mass index (LVMi) was calculated using CTA images. LA reverse remodeling was based on LASr and LAVi changes, whereas LV reverse remodeling was defined as an improvement in LV-GLS or a reduction of LVMi. The association of severely reduced LASr (<20%) at baseline with changes (Δ) in LASr, LAVi, LV-GLS and LVMi were analyzed using linear regression, and Cox proportional hazard model for mortality.ResultsMean LASr and LV-GLS were 17.7 ± 8.4 and −15.3 ± 3.4% at baseline and 20.2 ± 10.2 and −16.6 ± 4.0% at follow-up (p = 0.024 and p < 0.001, respectively). Severely reduced LASr at baseline was associated with more pronounced ΔLASr (β = 5.24, p = 0.025) and LVMi reduction on follow-up (β = 5.78, p = 0.036), however, the majority of the patients had <20% LASr on follow-up (44.4%). Also, ΔLASr was associated with ΔLV-GLS (adjusted β = 2.10, p < 0.001). No significant difference in survival was found between patients with baseline severely reduced LASr (<20%) and higher LASr (≥20%) (p = 0.054).ConclusionLV reverse remodeling based on LVMi was present even in patients with severely reduced LASr following TAVI, although extensive LA damage based on LA strain was demonstrated by its limited improvement over time.Clinical Trial Registration(ClinicalTrials.gov number: NCT02826200).https://www.frontiersin.org/articles/10.3389/fcvm.2022.841658/fullleft atrial functiontranscatheter aortic valve implantationreverse remodelingCT angiographyspeckle tracking echocardiography |
| spellingShingle | Borbála Vattay Anikó Ilona Nagy Anikó Ilona Nagy Astrid Apor Márton Kolossváry Aristomenis Manouras Milán Vecsey-Nagy Levente Molnár Melinda Boussoussou Andrea Bartykowszki Ádám L. Jermendy Tímea Kováts Emese Zsarnóczay Emese Zsarnóczay Pál Maurovich-Horvat Pál Maurovich-Horvat Béla Merkely Bálint Szilveszter The Predictive Value of Left Atrial Strain Following Transcatheter Aortic Valve Implantation on Anatomical and Functional Reverse Remodeling in a Multi-Modality Study Frontiers in Cardiovascular Medicine left atrial function transcatheter aortic valve implantation reverse remodeling CT angiography speckle tracking echocardiography |
| title | The Predictive Value of Left Atrial Strain Following Transcatheter Aortic Valve Implantation on Anatomical and Functional Reverse Remodeling in a Multi-Modality Study |
| title_full | The Predictive Value of Left Atrial Strain Following Transcatheter Aortic Valve Implantation on Anatomical and Functional Reverse Remodeling in a Multi-Modality Study |
| title_fullStr | The Predictive Value of Left Atrial Strain Following Transcatheter Aortic Valve Implantation on Anatomical and Functional Reverse Remodeling in a Multi-Modality Study |
| title_full_unstemmed | The Predictive Value of Left Atrial Strain Following Transcatheter Aortic Valve Implantation on Anatomical and Functional Reverse Remodeling in a Multi-Modality Study |
| title_short | The Predictive Value of Left Atrial Strain Following Transcatheter Aortic Valve Implantation on Anatomical and Functional Reverse Remodeling in a Multi-Modality Study |
| title_sort | predictive value of left atrial strain following transcatheter aortic valve implantation on anatomical and functional reverse remodeling in a multi modality study |
| topic | left atrial function transcatheter aortic valve implantation reverse remodeling CT angiography speckle tracking echocardiography |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.841658/full |
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