Clinical Interventions in Aging (Sep 2023)

Prognostic Value of Myocardial Function Imaging Markers in Elderly Patients Undergoing Transcatheter Aortic Valve Replacement

  • Dadarlat-Pop A,
  • Molnar A,
  • Serban A,
  • Tomoaia R,
  • Hagiu C,
  • Manole S,
  • Oprea A,
  • Mocanu L,
  • Picos A,
  • Mot S

Journal volume & issue
Vol. Volume 18
pp. 1597 – 1606

Abstract

Read online

Alexandra Dadarlat-Pop,1,2 Adrian Molnar,3,4,* Adela Serban,1,2,* Raluca Tomoaia,2,5 Claudia Hagiu,6,7,* Simona Manole,8,9,* Alexandru Oprea,3,4,* Lorena Mocanu,1 Andrei Picos,10,* Stefan Mot1,2 1Cardiology Department, Heart Institute Niculae Stăncioiu, Cluj-Napoca, Romania; 2Cardiology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; 3Cardiovascular Surgery Department, Heart Institute Niculae Stăncioiu, Cluj-Napoca, Romania; 4Cardiovascular Surgery Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; 5Cardiology Department, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania; 6Gastroenterology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; 7“Prof. Dr. Octavian Fodor” Regional Gastroenterology-Hepatology Institute, Cluj-Napoca, Romania; 8Radiology and Medical Imaging Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; 9Department of Radiology and Medical Imaging, Heart Institute Niculae Stăncioiu, Cluj-Napoca, Romania; 10Department of Prevention in Dental Medicine, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, Cluj-Napoca, Romania*These authors contributed equally to this workCorrespondence: Raluca Tomoaia, Email [email protected]: Transcatheter aortic valve replacement (TAVR) became the leading therapeutic strategy for aortic valve replacement in older patients with severe symptomatic aortic stenosis. Echocardiographic parameters that mark the left ventricle and right ventricle reverse remodeling after the TAVR are not well established. The aim of the current study is to describe the dynamics of both left ventricle (LV) and right ventricle (RV) strain derived from speckle tracking echocardiography in elderly patients at 3-months after the TAVR procedure.Methods: We enrolled 52 consecutive patients (77 ± 4.9 years old, median STS score of 3.1) who underwent transfemoral TAVR at our tertiary care center. All patients were evaluated at baseline and 3 months following TAVR.Results: The LV global longitudinal strain (GLS) 3-month following TAVR was significantly improved compared with baseline values (− 16 ± 4.2% vs − 16 ± 4.2%; p < 0.001) but no significant changes in the RV GLS 3 and 6 segments model following TAVR were registered. The LV ejection fraction was significantly improved 3-months after the TAVR procedure. LV-GLS at baseline demonstrated a strong positive correlation with LV-GLS at 3 months (r = 0.69) and a moderate correlation with RV strain parameters (r = 0.38 and r = 0.56), but also a negative correlation with LVEF at follow-up (r=− 0.61). Interestingly, in contrast to LVEF, none of the strain parameters correlated with age. NT-proBNP values were correlated with both LV-GLS (r = 0.37) and LVEF (r=− 0.5) at baseline. However, at follow-up, baseline NT-proBNP values remained correlated only to LV-GLS at 3-months (r = 0.24), but the correlation was weak.Keywords: elderly population, transcatheter aortic valve replacement, aortic stenosis, global longitudinal strain, outcome

Keywords