• Sebastian Spethmann, Henryk Dreger, Gerd Baldenhofer, Katharina Stüer, Davit Saghabalyan, Eda Müller, Robert Hättasch, Verena Stangl, Michael Laule, Gert Baumann, Karl Stangl, and Fabian Knebel.
• Medizinische Klinik für Kardiologie und Angiologie, Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.
• J Am Soc Echocardiogr. 2013 Jan 1;26(1):64-71.e2.

BackgroundAortic stenosis (AS) leads to remodeling of the left heart. Strain measurements enable the assessment of left atrial (LA) mechanics. The goal of this study was to evaluate the short-term effects of transcatheter aortic valve implantation (TAVI) on LA myocardial deformation as well as left ventricular (LV) diastolic function.MethodsThirty-two patients with severe AS were prospectively enrolled and examined before and 8.2 ± 3.3 days after TAVI. Speckle-tracking echocardiography of the basal septal and lateral segments of the left atrium was performed to determine peak positive strain (R(LA)), strain during early diastole (E(LA)), and, if feasible, strain during atrial contraction (A(LA)). Assessment of LV diastolic function included standard indices, the atrial fraction, and LA volumes.ResultsCompared with baseline, the mean atrial reservoir (R(LA)) (24.0 ± 11.2% vs 32.2 ± 14.0%, P < .001) and conduit function (R(LA) - E(LA)) (13.9 ± 5.5% vs 20.8 ± 8.1%, P < .001) improved significantly after TAVI. There was a significant reduction in deceleration time (242 ± 56 vs 195 ± 65 msec, P < .001) and an improvement of pulsed-wave tissue Doppler-derived E' (5.5 ± 1.8 vs 7.3 ± 2.3 cm/sec, P = .01). Regarding LA volumes, only the minimal LA volume index changed significantly. In contrast, there was no improvement in atrial contraction, that is, contractile function (E(LA) - A(LA)) and atrial fraction. Moreover, the E/E' ratio remained unchanged.Conclusions8.2 ± 3.3 days after TAVI, only the reservoir and conduit function of the left atrium improved, whereas LA contraction and LA volumes, except for the systolic volume index, remained unchanged. This was accompanied by improvement of early LV diastolic function, indicating acute recovery of LV relaxation and LA function.Copyright © 2013 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

28 keywords...

hide…