Changes in myocardial deformation after transcatheter and surgical aortic valve replacement.
Speckle tracking echocardiography (STE) has emerged as a novel angle-independent modality in assessing myocardial velocity, deformation, and strain. Its role in assessing change before and after aortic valve replacement in patients with aortic stenosis (AS) has recently generated interest. This review summarizes the practical utility and clinical implications of myocardial deformation by STE after surgical or transcatheter aortic valve replacement (TAVR). Overall, atrial strain and ventricular strain as measured by STE improve after surgical and transcatheter aortic intervention in short- and long-term follow-up with evidence of a more pronounced acute improvement in patients who undergo TAVR. STE assessment of strain, particularly global longitudinal strain, can detect subtle changes in myocardial systolic function prior to conventional variables such as left ventricular ejection fraction and is clinically useful in predicting mortality and symptom development in patients with AS. This underscores the emerging role of STE in monitoring post-procedural improvements in cardiac function as well as the potential value in guiding optimal timing of AS intervention.
Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
Vinisha
http://orcid.org/0000-0001-8889-1722
V
Garg
Department of Anesthesiology & Perioperative Medicine, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
Jonathan K
JK
Ho
Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
Gabriel
G
Vorobiof
D001021:Aortic Valve / Q000601:surgery*; D004452:Echocardiography; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods
aortic stenosis; aortic valve replacement; global longitudinal strain; speckle tracking echocardiography; strain