• Masahiko Asami, Thomas Pilgrim, Jonas Lanz, Dik Heg, Anna Franzone, Raffaele Piccolo, Bettina Langhammer, Fabien Praz, Lorenz Räber, Marco Valgimigli, Eva Roost, Stephan Windecker, and Stefan Stortecky.
• Department of Cardiology (M.A., T.P., J.L., A.F., R.P., F.P., L.R., M.V., S.W., S.S.).
• Circ Cardiovasc Interv. 2019 Jan 1; 12 (1): e006612.

BackgroundThe left-ventricular myocardial performance index Tei is an echocardiographic parameter that incorporates the information of systolic and diastolic time intervals. While the prognostic value of selected systolic and diastolic parameters is well established after transcatheter aortic valve replacement, the role of Tei has not been evaluated in this setting.Methods And ResultsBetween August 2007 and December 2015, consecutive patients with symptomatic, severe aortic stenosis and transthoracic echocardiography pre- and post-transcatheter aortic valve replacement were considered eligible for this analysis. The primary end point was all-cause mortality at 1 year after transcatheter aortic valve replacement. Of 824 patients with echocardiographic images to calculate Tei, pre-Tei was normal (<0.45) in 639 and high (≥0.45) in 185, whereas post-Tei was normal in 602 and high in 120, respectively. After adjustment for confounding factors, high pre-Tei was associated with an increased risk of all-cause mortality at 30 days (adjusted hazard ratio [HRadj] 3.62; 95% CI, 1.89-6.91) and 1 year (HRadj 2.56; 95% CI, 1.78-3.69). Similarly, post-Tei was associated with an increased risk of mortality between 30 days and 1-year follow-up (HRadj 6.70; 95% CI, 4.22-10.63). At multivariable analysis Tei emerged as an independent predictor of early (pre-Tei index per 0.1-HRadj 1.40; 95% CI, 1.23-1.60) and late mortality (post-Tei index per 0.1-HRadj 1.40; 95% CI, 1.31-1.50), respectively.ConclusionsThe left-ventricular myocardial performance index Tei is associated with impaired clinical outcomes during short- and longer-term follow-up after transcatheter aortic valve replacement.Clinical Trial RegistrationURL: https://www.clinicaltrials.gov . Unique identifier: NCT01368250.

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