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Effect of transcatheter aortic valve replacement on left atrial function
Author(s) -
Truong Vien T.,
Chung Eugene,
Nagueh Sherif,
Kereiakes Dean,
Schaaf Jennifer,
Volz Brian,
Ngo Tam N. M.,
Mazur Wojciech
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14109
Subject(s) - cardiology , medicine , atrial fibrillation , sinus rhythm , valve replacement , stenosis
Objectives To investigate the effect of transcatheter aortic valve replacement on left atrial volumetric function and left atrial volume for the prediction of adverse outcomes. Methods This is a retrospective analysis of 121 patients in sinus rhythm who underwent TAVR for severe AS . Maximum LA volume index ( LAVI max), minimum LA volume index ( LAVI min), and “pre‐A” volume index ( LAVI pre‐A, the volume before atrial contraction) were measured by biplane Simpson's method at baseline, 1 month, and 1 year. The reservoir function, conduit function, booster pump function were calculated. All patients were followed for new‐onset of atrial fibrillation, hospitalization and all‐cause mortality. Results The reservoir function, conduit function and booster function before TAVR were 46%, 21%, 32%, respectively. LA volumetric function assessment demonstrated that reservoir function, conduit function increased over the time (all P < 0.01). There was no difference in booster function after TAVR ( P = 0.18). Baseline markedly enlarged LA was significantly increased for AF ( HR : 4.72; 95% CI , 1.11‐20.13, P = 0.04). In addition, There was a progressive decrease in LAVI max ( P = 0.02) and RVSP ( P = 0.03) over the time in non‐ AF group but not in AF group ( P = 0.62 and P = 0.65, respectively). Although, the proportion of high left ventricular filling pressure decreased in both groups but a marked decrease was noted in non AF group in compared with AF group. Conclusion Reservoir function, conduit function increased over time. Lack of negative LA remodeling post TAVR was associated with higher incidence of AF .