Right ventricular free wall longitudinal strain (RVFWSL) a new outcome predictor in patients candiate for TAVI. (3rd October 2022)

• Record Type: Journal Article
• Authors: Dellino, C; Pergola, V; Torresan, F; Cecchetto, A; Aruta, P; Tarantini, G; Fraccaro, C; Mele, D; Iliceto, S
• Is Part Of: European heart journal. Volume 43(2022)Supplement 2
• Publication Date: 2022-10-03
• Subjects: Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehac544.016
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Right ventricular (RV) systolic dysfunction is considered an outcome predictor in various cardiovascular diseases. RV dysfunction, assessed by RV free wall longitudinal strain (RVFWSL) in patients candidate for trans-catheter aortic valve implantation (TAVI), has not been extensively explored as an outcome predictor. Purpose: Evaluate the prognostic value of pre intervention RVFWSL in patients undergoing TAVI. Methods: Retrospective analysis of 100 patients who underwent transfemoral TAVI in our hospital from 2015 to 2019, with at least a pre and post-TAVI echocardiography. Clinical and echocardiographic data before and after TAVI and follow-up data were collected. We considered the value of [23.3]% the cut-off of normality for RVFWSL. The primary end-point was a composite of death from any cause and hospitalization for heart failure. Results: The median age of the patients was 81 years (79–83) with a functional status NYHA II–III (81%) before the intervention. EF was preserved in most of the patients (median 56%, 55–58), while Right ventricle dysfunction assessed with RVFWLS was reduced in half of the patients at baseline. At a median follow-up of 1023 days (630–1387), the univariate analysis demonstrated a predictive value for a reduced RVFWSL (<[23.3]%, P=0.015) and EF<50% (P=0.014) before TAVI. Cox regression analysis found that pre-TAVI reduced RVFWSL (HR 2.875, 95% CI: 1.113–7.425; P=0.03) and EF <50% (HR 2.511, 95% CI: 1.07–5.892; P=0.03) were independently associated with composite end-point of the study. Moreover, a reduced EF associated with RVFWSL <[23.3]% showed an incremental value in predicting the outcome (P=0.021). Conclusions: Among patients with severe aortic stenosis undergoing TAVI, a reduced pre-implant RVFWSL is able to predict long-term outcome. Funding Acknowledgement: Type of funding sources: None.