Abstract 19223: Left Ventricular Strain Rate Can Predict Rehospitalizations With Congestive Heart Failure After Transcatheter Aortic Valve Replacement
Background: Transcatheter aortic valve replacement (TAVR) has become important treatment of choice for severe aortic stenosis in patients with high surgical risks. However, previous report demonstrated high readmitting rate for heart failure (HF) despite TAVR treatment. Myocardial strain is a sensitive marker for subtle myocardial damage. We hypothesized that myocardial strain can predict post TAVR readmission for HF.
Methods: One-hundred patients who underwent TAVR treatment with Edwards Sapien were retrospectively reviewed. Using offline software, speckle tracking methods derived left ventricular longitudinal strain and strain rate at systole, early and late diastole, were measured from four chamber view before and a week after TAVR procedure. For the follow-up, medical records are reviewed after 1 year of TAVR procedure. Patient who had post TAVR readmission for HF (HF group) and who had no readmission for HF (non-HF group) within 1 year were compared.
Results: Seventy patients (age 83±6 yo, male 41%) were enrolled. Thirty patients were excluded due to the presence of atrial fibrillation (16), poor image quality for analysis (11), history of cardiac surgery (3). 59% of the patient had symptom of dyspnea before TAVR. After TAVR, 6 patients (8.6%) admitted for heart failure within 1 year. From the parameters before TAVR procedure, HF group had higher serum creatinine level (1.24 vs. 0.9 mg/dL, p=0.02) than non-HF group, but no difference in conventional and strain echocardiographic parameters. From post TAVR procedure parameters, late diastolic strain rate (0.26 vs. 0.53, p<0.01) and transmitral flow (69 vs. 113 cm/s, p<0.01) were lower in HF group than non-HF group.
Conclusion: Reduced late diastolic strain rate found just after TAVR is one of the risk factors of producing HF readmission within 1 year despite TAVR treatment.
Author Disclosures: M. Amaki: Research Grant; Modest; suzuken memorial foundation. A. Okada: None. Y. Shimahara: None. H. Kanzaki: None. Y. Hamatani: None. H. Takahama: None. T. Hasegawa: None. Y. Sugano: None. T. Fujita: None. J. Kobayashi: None. Y. Satoshi: None. T. Anzai: None.
- © 2016 by American Heart Association, Inc.