Details

Autor(en) / Beteiligte

• Stens, Niels A
• van Iersel, Odette
• Rooijakkers, Max J P
• van Wely, Marleen H
• Nijveldt, Robin
• Bakker, Esmée A
• Rodwell, Laura
• Pedersen, Anders L D
• Poulsen, Steen H
• Kjønås, Didrik
• Stassen, Jan
• Bax, Jeroen J
• Tanner, Felix C
• Lerakis, Stamatios
• Shimoni, Sara
• Poulin, Frédéric
• Ferreira, Vera
• Reskovic Luksic, Vlatka
• van Royen, Niels
• Thijssen, Dick H J

Titel

Prognostic Value of Preprocedural LV Global Longitudinal Strain for Post-TAVR-Related Morbidity and Mortality: A Meta-Analysis

Ist Teil von

• JACC. Cardiovascular imaging, 2023-03, Vol.16 (3), p.332-341

Ort / Verlag

United States

Erscheinungsjahr

2023

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• Left ventricular ejection fraction (LVEF) demonstrates limited prognostic value for post-transcatheter aortic valve replacement (TAVR) outcomes. Evidence regarding the potential role of left ventricular global longitudinal strain (LV-GLS) in this setting is inconsistent. The aim of this systematic review and meta-analysis of aggregated data was to evaluate the prognostic value of preprocedural LV-GLS for post-TAVR-related morbidity and mortality. The authors searched PubMed, Embase, and Web of Science for studies investigating the association between preprocedural 2-dimensional speckle-tracking-derived LV-GLS and post-TAVR clinical outcomes. An inversely weighted random effects meta-analysis was adopted to investigate the association between LV-GLS vs primary (ie, all-cause mortality) and secondary (ie, major cardiovascular events [MACE]) post-TAVR outcomes. Of the 1,130 identified records, 12 were eligible, all of which had a low-to-moderate risk of bias (Newcastle-Ottawa scale). On average, 2,049 patients demonstrated preserved LVEF (52.6% ± 1.7%), but impaired LV-GLS (-13.6% ± 0.6%). Patients with a lower LV-GLS had a higher all-cause mortality (pooled HR: 2.01; 95% CI: 1.59-2.55) and MACE (pooled odds ratio [OR]: 1.26; 95% CI: 1.08-1.47) risk compared with patients with higher LV-GLS. In addition, each percentage point decrease of LV-GLS (ie, toward 0%) was associated with an increased mortality (HR: 1.06; 95% CI: 1.04-1.08) and MACE risk (OR: 1.08; 95% CI: 1.01-1.15). Preprocedural LV-GLS was significantly associated with post-TAVR morbidity and mortality. This suggests a potential clinically important role of pre-TAVR evaluation of LV-GLS for risk stratification of patients with severe aortic stenosis. (Prognostic value of left ventricular global longitudinal strain in patients with aortic stenosis undergoing Transcatheter Aortic Valve Implantation: a meta-analysis; CRD42021289626).