Kassem Jad, Ghazal Rachad, Fakhreddin Omar, Jaber Farah, Sarkis Patrick, Yahya Nabil, Younes Joe, Francis Jamil, Sawaya Fadi
Department of Radiology, Mount Sinai West, New York, NY, USA.
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
J Cardiovasc Echogr. 2025 Apr-Jun;35(2):129-135. doi: 10.4103/jcecho.jcecho_99_24. Epub 2025 Jul 30.
Transcatheter aortic valve replacement (TAVR) is a well-established therapeutic option for all risk patients with symptomatic severe aortic stenosis (AS). While TAVR primarily addresses AS, its benefits extend beyond the valve itself. Recent studies suggest possible restoration of left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) following TAVR. This study aims to assess changes in LV GLS in patients undergoing TAVR, which may serve as a subclinical indicator of improved LV mechanics.
This retrospective study included patients with severe AS who underwent TAVR at the American University of Beirut Medical Center from January 2017 to January 2023. Baseline and 1-year echocardiography parameters were compared, and GLS was calculated to assess the impact of TAVR on LV function.
A total of 80 patients (mean age: 81.3 ± 7.8 years; 38.8% of women; 88.8% hypertensive) who underwent TAVR for severe AS were included in the final analysis. One-year post-TAVR, echocardiographic studies showed a significant reduction in interventricular septum diameter (13.3 ± 2.3 mm vs. 12 ± 1.8 mm, < 0.001) and LV mass index (LVMI) (113.6 ± 26.6 g/m vs. 96 ± 30.3 g/m, < 0.001). LVEF showed a modest improvement (59.2 ± 12.3% vs. 62.1 ± 7.6%, < 0.01). LV GLS significantly improved from -16.8 ± 4.6% to -19.2 ± 3.3% ( < 0.001). Baseline LVMI, LVEF, and GLS correlate with the GLS change (ΔGLS) post-TAVR.
GLS significantly improves 1 year after TAVR, indicating an overall improvement in LV performance. The degree of improvement in GLS correlates with baseline LVMI and systolic function.
经导管主动脉瓣置换术（TAVR）是所有有症状的重度主动脉瓣狭窄（AS）患者公认的治疗选择。虽然TAVR主要解决AS问题，但其益处不仅限于瓣膜本身。最近的研究表明，TAVR后左心室射血分数（LVEF）和整体纵向应变（GLS）可能恢复。本研究旨在评估接受TAVR患者的左心室GLS变化，这可能是左心室力学改善的亚临床指标。
这项回顾性研究纳入了2017年1月至2023年1月在贝鲁特美国大学医学中心接受TAVR的重度AS患者。比较基线和1年时的超声心动图参数，并计算GLS以评估TAVR对左心室功能的影响。
最终分析纳入了80例因重度AS接受TAVR的患者（平均年龄：81.3±7.8岁；女性占38.8%；高血压患者占88.8%）。TAVR术后1年，超声心动图研究显示室间隔直径显著减小（13.3±2.3毫米对12±1.8毫米，<0.001）和左心室质量指数（LVMI）显著减小（113.6±26.6克/平方米对96±30.3克/平方米，<0.001）。LVEF有适度改善（59.2±12.3%对62.1±7.6%，<0.01）。左心室GLS从-16.8±4.6%显著改善至-19.2±3.3%（<0.001）。基线LVMI、LVEF和GLS与TAVR术后的GLS变化（ΔGLS）相关。
TAVR术后1年GLS显著改善，表明左心室性能总体改善。GLS的改善程度与基线LVMI和收缩功能相关。
