Prognostic implications and alterations in left atrial deformation following transcatheter aortic valve implantation
Butcher, Steele (Cincinnati Children's Hospital Medical Center (CCHMC). Center for Fetal and Placental Research)
Hirasawa, Kensuke (Tokyo Medical and Dental University)
Meucci, Maria Chiara (Fondazione Policlinico Universitario A. Gemelli IRCCS)
Stassen, Jan (Jessa Hospital Hasselt)
Kuneman, Jurrien H. (Leiden University Medical Center)
Pereira, Ana Rita (Hospital Garcia de Orta)
Van Der Kley, Frank (Department of Cardiology. Heart Lung Center. Leiden University Medical Center)
De Weger, Arend (Leiden University Medical Center)
Van Rosendael, Philippe J. (Leiden University Medical Center)
Marsan, Nina Ajmone (Leiden University Medical Center)
Playford, David (University of Notre Dame)
Delgado, Victoria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bax, Jeroen J (University of Turku)

Data:	2024
Resum:	Aims: To evaluate the prognostic implications of the left atrial reservoir strain-defined diastolic dysfunction (LARS-DD) grade in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) and to determine whether post-TAVI LARS was more closely associated with new-onset atrial fibrillation than pre-TAVI LARS. Methods and results: Pre-TAVI LARS-DD was evaluated by speckle-tracking echocardiography and was assigned as Grade 0 to 1 (LARS ≥24%), Grade 2 (LARS 19-24%), and Grade 3 (LARS <19%). Patients were followed up for the primary endpoint of all-cause mortality from the date of TAVI. For the secondary endpoint, patients with pre- and post-TAVI LARS measurements and no history of atrial fibrillation were evaluated for the occurrence of new-onset atrial fibrillation. A total of 601 patients [median age 81 (76-85) years, 53% males] were included. Overall, 169 patients (28%) were LARS-DD Grade 0/1, 96 patients (16%) were LARS-DD Grade 2, and 336 (56%) were LARS-DD Grade 3. Over a median follow-up of 40 (interquartile range 26-58) months, a total of 258 (43%) patients died. In a comprehensive multivariable Cox regression model, the LARS-DD grade was independently associated with all-cause mortality [adjusted hazard ratio (HR) 1. 28 per one-grade increase, 95% confidence interval (CI) 1. 07-1. 53, P = 0. 007]. For the secondary endpoint of new-onset atrial fibrillation, a total of 285 patients were evaluated. Post-TAVI LARS (subdistributional HR 1. 14 per 1% <20%, 95% CI 1. 05-1. 23, P = 0. 0009), but not pre-TAVI LARS (P = 0. 93), was independently associated with new-onset atrial fibrillation. Conclusion: An increased LARS-DD grade was independently associated with long-term post-TAVI survival in patients with severe AS. Post-TAVI LARS was closely related to the occurrence of new-onset atrial fibrillation.
Nota:	Altres ajuts: European Society of Cardiology (ESC Research Grant App000080404, R-2018-18122)
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	TAVI ; Aortic stenosis ; Diastolic dysfunction ; Left atrial strain ; Outcome
Publicat a:	European Heart Journal Cardiovascular Imaging, Vol. 25 Núm. 12 (November 2024) , p. 1638-1648, ISSN 2047-2412

DOI: 10.1093/ehjci/jeae170
PMID: 38984693

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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