Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study.
BACKGROUND
Chronic increased afterload due to severe aortic stenosis (AS) results in com-pensatory concentric left ventricular (LV) hypertrophy and LV dysfunction. These in turn cause remodeling of the left heart. The aim of this study was to investigate the acute effect of transcatheter aortic valve implantation (TAVI) on left atrial (LA) mechanics and LV diastolic function.


METHODS
The study consisted of a total of 35 consecutive patients (mean age was 77.7 ± 5.0 years, 25 female) undergoing TAVI. All TAVI procedures have been performed under the transesophageal echocardiography (TEE) guidance. Before and 24 h after TAVI, all patients underwent transthoracic echocardiography (TTE) and mitral inflow velocities with pulsed-wave (PW) Doppler including early filling wave (E), late diastolic filling wave (A), and E/A ratio were obtained. LV diastolic function was also explored by pulsed tissue Doppler imaging (TDI). Early (E') and late (A') diastolic annular velocities, E'/A' ratio and E/E' ratio were obtained. In addition, during the procedure before and minutes after the valve implantation, the left atrial appendage-peak antegrade flow velocity (LAA-PAFV) was measured and recorded with TEE.


RESULTS
Compared with baseline, the mean mitral E, septal E' and E'/A' ratio increased significantly after TAVI. In addition, the LAA-PAFV increased significantly within minutes of TAVI (32.45 ± 10.7 cm/s vs. 47.6 ± 12.6 cm/s, p < 0.001).


CONCLUSIONS
TAVI improves LV diastolic function and LA performance immediately.
Department of Cardiology, Ankara Ataturk Education and R esearch Hospital, Ankara, Turkey. cengaver61@yahoo.com.
Cenk
C
Sarı
Abdullah Nabi
AN
Aslan
Serdal
S
Baştuğ
Murat
M
Akçay
Nihal
N
Akar Bayram
Emine
E
Bilen
Hüseyin
H
Ayhan
Hacı Ahmet
HA
Kasapkara
Tahir
T
Durmaz
Telat
T
Keleş
Engin
E
Bozkurt
D000368:Aged; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D016279:Atrial Function, Left / Q000502:physiology*; D003971:Diastole; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D065467:Transcatheter Aortic Valve Replacement; D016277:Ventricular Function, Left / Q000502:physiology*
aortic valve stenosis; diastolic dysfunction; left atrial appendage function; transcatheter aortic valve implantation