Impact of left atrial strain assessed with feature-tracking computed tomography on long-term mortality after transcatheter aortic valve implantation. (14th October 2021)

• Record Type: Journal Article
• Authors: Hirasawa, K; Singh, G K; Kuneman, J H; Ajmone Marsan, N; Delgado, V; Bax, J J
• Is Part Of: European heart journal. Volume 42(2021)Supplement 1
• Publication Date: 2021-10-14
• Subjects: Computed Tomography Imaging of Structural Heart Disease; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab724.0166
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Aortic stenosis (AS) induces left atrial (LA) remodeling through the increase of left ventricular (LV) filling pressure. Peak left atrial longitudinal strain (PALS) has been proposed as a prognostic marker in patients with AS. Novel feature-tracking (FT) software allows to assess LA strain from multidetector computed tomography (MDCT) dataset. Purpose: To investigate the association between PALS using FT MDCT and moratlity in patients who underwent transcatheter aortic valve implantation (TAVI). Methods: A total of 369 Patients (mean 80±7 years, 51% male) who underwent preprocedual MDCT before TAVI and had suitable data for measureing PALS using dedicated FT software were included. Patients were classified into 4 groups according to PALS quartiles; PALS more than 19.3% (Q1), 19.3% or less to more than 15.0% (Q2), 15.0% or less to more than 9.1% (Q3), and 9.1% or less (Q4). The primary outcome was all-caurse mortality. Results: During median follow-up of 45 [22 - 68] months, 124 patients (34%) were died. On multivariable Cox regression analysis, PALS is an independently associated with all-cause mortality (HR: 0.958 [95% CI: 0.925–0.993], P=0.006). Kaplan-Meier analysis showed the worse outcome of the quatile with more impaired PALS (Logrank P<0.001). Compared to Q1, Q3 and Q4 had higher risk of mortality after TAVI (HR: 2.475 [95% CI: 1.411–4.340] for Q3, HR: 3.253 [95% CI: 1.878–5.633] for Q4). Conclusion: In this retrospective study, PALS measured with FT MDCT was strongly associated with all-cause mortality after TAVI. LA functial assessment using MDCT may have a importan role for risk stratification in patients referred to TAVI. Funding Acknowledgement: Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): ESC research grant 2018