Bergeijk, K.H. van (2020) Left Atrial Strain as a predictor of clinical outcome after Transcatheter Aortic Valve Implantation: a promising approach. thesis, Medicine.
Full text available on request.Abstract
Introduction A transcatheter aortic valve implantation (TAVI) procedure has become an alternative treatment for patients with aortic stenosis (AS). Despite increased experience, complications still occur. Frequent clinical events after a TAVI-procedure are heart failure hospitalization (in particular heart failure with preserved ejection fraction, HFpEF) and (new�onset) atrial fibrillation (NOAF). Remodeling of the left atrium (LA) seems to be a key feature in the pathophysiology of both AF and HFpEF. We therefore studied the predictive value of left atrial size and function by Speckle Tracking Echocardiography (STE) for heart failure hospitalization and NOAF post-TAVI. Method Patients receiving a TAVI-procedure in the UMCG between 2009 and 2019, were retrospective analyzed. Left atrial size and function (LA Strain) where obtained both pre- and post-TAVI. HF-hospitalization and NOAF were captured from the electronic medical records. Results In total 91 patients were eligible for this study. Median follow-up was 1280 (range of 886-1949) days. During follow-up HF-hospitalization or death occurred in 43 patients (47%). LA Reservoir strain was lower in patients with versus without an event (24.45 vs 29.09 p=0.070). In a multivariable stepwise analysis, a history of HF turned out to be the strongest predictor of worse clinical outcome. Although worsening of LA Strain was associated with worse outcomes, but the change in LA Strain was not an independent predictor of outcome. NOAF occurred in 5 patients. No predictors for NOAF were found. Conclusion A history of heart failure was the strongest predictor of death or heart failure hospitalization post-TAVI. Left atrial function and change in LA function were associated with clinical outcomes, but were not independent predictors in multivariable models.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Voors, prof. dr. A.A. and Melle, dr. J.P. van and Wykrzykowska, dr. J.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 16 Dec 2021 15:21 |
| Last Modified: | 16 Dec 2021 15:21 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2885 |
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