Right vs. left ventricular longitudinal strain for mortality prediction after transcatheter aortic valve implantation. 2023

Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
Department of Cardiology, University Heart Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

This study aims at exploring biventricular remodelling and its implications for outcome in a representative patient cohort with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). Pre-interventional echocardiographic examinations of 100 patients with severe AS undergoing TAVI were assessed by speckle tracking echocardiography of both ventricles. Association with mortality was determined for right ventricular global longitudinal strain (RVGLS), RV free wall strain (RVFWS) and left ventricular global longitudinal strain (LVGLS). During a median follow-up of 1,367 [959-2,123] days, 33 patients (33%) died. RVGLS was lower in non-survivors [-13.9% (-16.4 to -12.9)] than survivors [-17.1% (-20.2 to -15.2); P = 0.001]. In contrast, LVGLS as well as the conventional parameters LV ejection fraction (LVEF) and RV fractional area change (RVFAC) did not differ (P = ns). Kaplan-Meier analyses indicated a reduced survival probability when RVGLS was below the -14.6% cutpoint (P < 0.001). Lower RVGLS was associated with higher mortality [HR 1.13 (95% CI 1.04-1.23); P = 0.003] independent of LVGLS, LVEF, RVFAC, and EuroSCORE II. Addition of RVGLS clearly improved the fitness of bivariable and multivariable models including LVGLS, LVEF, RVFAC, and EuroSCORE II with potential incremental value for mortality prediction. In contrast, LVGLS, LVEF, and RVFAC were not associated with mortality. In patients with severe AS undergoing TAVI, RVGLS but not LVGLS was reduced in non-survivors compared to survivors, differentiated non-survivors from survivors, was independently associated with mortality, and exhibited potential incremental value for outcome prediction. RVGLS appears to be more suitable than LVGLS for risk stratification in AS and timely valve replacement.

UI MeSH Term Description Entries

Related Publications

Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
July 2023, The American journal of cardiology,
Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
February 2022, World journal of clinical cases,
Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
March 2020, Journal of cardiac surgery,
Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
April 2020, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography,
Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
June 2021, Circulation journal : official journal of the Japanese Circulation Society,
Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
December 2013, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions,
Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
January 2018, PloS one,
Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
April 2014, The Journal of thoracic and cardiovascular surgery,
Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
July 2019, AsiaIntervention,
Neria E Winkler, and Shehab Anwer, and Kelly A Reeve, and Jonathan M Michel, and Albert M Kasel, and Felix C Tanner
December 2021, Journal of clinical medicine,
Copied contents to your clipboard!