Abstract 15971: Impact of Transcatheter Pulmonary Valve Replacement on Biventricular Strain and Synchrony Assessed by Cardiac Magnetic Resonance Feature Tracking
Transcatheter pulmonary valve (TPV) replacement is an emerging therapy intended to restore pulmonary valve function in patients with right ventricular outflow tract (RVOT) conduit dysfunction. We sought to demonstrate the impact of this technique on biventricular strain and synchrony. CMR data acquired at one center as part of the US Melody TPV trial were retrospectively analyzed. Biventricular strain and mechanical synchrony measurements were made based on short-axis and 4-chamber SSFP images using feature tracking software. Post- vs pre-TPV replacement findings were compared for all patients (n=31) and subgroups with predominant pulmonary regurgitation (PR, n=13) or stenosis (PS, n=18). Most patients had tetralogy of Fallot (18/31). Changes in strain following TPV replacement are summarized in Table 1. LV circumferential strain increased for the whole cohort (p<0.001) and both subgroups (PR p<0.009; PS p=0.02). LV longitudinal strain increased for the whole cohort (p=0.02) and PR subgroup (p=0.05); circumferential RV strain increased for the PS group only (p=0.05). Table 2 summarizes pre- and post- TPV synchrony results. LV longitudinal synchrony improved significantly in the PR group (maximum wall delay p=0.04, cross-correlation delay p=0.009). In conclusion, in patients with RVOT conduit dysfunction, TPV replacement is associated with improved global left ventricular strain, as well as improved RV strain and LV synchrony in subgroups. Given associations between strain and synchrony and clinical outcomes, these findings support potential long-term benefits of TPV replacement.
- © 2013 by American Heart Association, Inc.