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Prognostic influence of MDCT-derived global left ventricular longitudinal strain in patients with aortic stenosis treated with transcatheter aortic valve implantation

Session Advanced applications of cardiac strain imaging

Speaker Tea Gegenava

Congress : ESC Congress 2019

  • Topic : imaging
  • Sub-topic : Computed Tomography: Systolic and Diastolic Function
  • Session type : Rapid Fire Abstracts
  • FP Number : 4935

Authors : T Gegenava (Leiden,NL), P Bijl (Leiden,NL), M Vollema (Leiden,NL), F Kley (Leiden,NL), A Weger (Leiden,NL), D Hautemann (Leiden,NL), J Reiber (Leiden,NL), N Ajmone-Marsan (Leiden,NL), J Bax (Leiden,NL), V Delgado (Leiden,NL)

Authors:
T Gegenava1 , P Bijl1 , M Vollema1 , F Kley1 , A Weger1 , D Hautemann1 , J Reiber1 , N Ajmone-Marsan1 , J Bax1 , V Delgado1 , 1Leiden University Medical Centre - Leiden - Netherlands (The) ,

Citation:

Introduction: Transcatheter aortic valve implantation (TAVI) is an effective treatment for patients with severe aortic stenosis (AS), It can lead to an improvement in symptoms and quality of life but there is also an increasing recognition that some patients simply fail to derive a functional, morbidity, or mortality benefit post-TAVI. Left ventricular (LV) ejection fraction is the LV systolic function parameter to risk stratify patients with severe AS. However, LV global longitudinal strain (GLS)  provides incremental prognostic value to LVEF. Computed tomography plays an essential role in the evaluation of TAVI candidates. Novel software permits analysis of LV GLS from dynamic  Multi-detector row computed tomography (MDCT) data . Purpose: the present study aimed at investigating the prognostic value of MDCT-derived LV GLS in patients undergoing TAVI. Methods: LV GLS was measured on dynamic MDCT using novel CT- software (Figure, panel A) at baseline. Patients were followed up for all-cause mortality and cumulative event rates were analyzed with Kaplan-Meier method. Results: A total 214 patients (51% male, 80±7 years) were analysed retrospectively. Mean value of MDCT-derived LV GLS was -12.5±4%. During a median follow-up of 1378 days (interquartile range: 881-1895 days), 67 (31%) patients died. The Kaplan-Meier curve shows, that TAVI recipients with MDCT-derived LV GLS>-14% experienced higher cumulative rates of all-cause mortality, compared to patients with MDCT-derived LV GLS=-14% (Chi-square 10.549; Log rank p=0.001) (Figure, panel B). On  uni- and multivariate Cox-regression models, MDCT-derived LV GLS demonstrated significant association with all-cause mortality (hazard ratio [HR]: 0.851; 95% confidence interval [CI]: 0.772-0.937; p=0.001). Conclusions: MDCT-derived LV GLS is independently associated with all-cause mortality in patients treated with TAVI.

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