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Short-term effects of transcatheter aortic valve implantation on left atrial appendage function
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Abstract
Background: The beneficial effects of the transcatheter aortic valve implantation (TAVI) on echocardiographic parameters including left atrial (LA) and left ventricular (LV) functions were described by previous studies. The aim of this study was to analyze the effects of TAVI on left atrial appendage (LAA) function assessed by transthoracic and transesophageal echocardiography.
Methods: Fifty-five patients with severe symptomatic aortic stenosis were included in this prospective study. LAA early and late emptying velocities, LAA filling velocity, peak early diastolic (EM), late diastolic (AM), and systolic (SM) velocities were measured with pulsed wave Doppler and tissue Doppler imaging, and E/Em ratio was calculated before and 7.1 ± 2.8 days after TAVI. A subgroup analysis was performed in accordance with the left ventricular ejection fraction (LVEF) of the patients and the severity of their LV diastolic dysfunction.
Results: Although the post-procedure peaks and mean gradients of the patients decreased significantly, the LVEF increased significantly in those who had low LVEF before the procedure. The post-procedure E/Em ratio decreased significantly (p < 0.001). The post-procedural LAA mean filling velocity and EM velocity were significantly higher than the pre-procedural filling velocity (p < 0.001, p = 0.002, respectively). In the subgroup analysis, the post-procedural LAA filling velocity, early and late LAA emptying velocities, in addition to the mean velocity of the EM, AM, and SM were significantly higher than before the procedure in patients with LVEF of < 50% and E/Em ratios of > 15.
Conclusions: LAA function improved soon after the TAVI procedure, especially in patients with low LVEF and marked LV diastolic dysfunction.
Abstract
Background: The beneficial effects of the transcatheter aortic valve implantation (TAVI) on echocardiographic parameters including left atrial (LA) and left ventricular (LV) functions were described by previous studies. The aim of this study was to analyze the effects of TAVI on left atrial appendage (LAA) function assessed by transthoracic and transesophageal echocardiography.
Methods: Fifty-five patients with severe symptomatic aortic stenosis were included in this prospective study. LAA early and late emptying velocities, LAA filling velocity, peak early diastolic (EM), late diastolic (AM), and systolic (SM) velocities were measured with pulsed wave Doppler and tissue Doppler imaging, and E/Em ratio was calculated before and 7.1 ± 2.8 days after TAVI. A subgroup analysis was performed in accordance with the left ventricular ejection fraction (LVEF) of the patients and the severity of their LV diastolic dysfunction.
Results: Although the post-procedure peaks and mean gradients of the patients decreased significantly, the LVEF increased significantly in those who had low LVEF before the procedure. The post-procedure E/Em ratio decreased significantly (p < 0.001). The post-procedural LAA mean filling velocity and EM velocity were significantly higher than the pre-procedural filling velocity (p < 0.001, p = 0.002, respectively). In the subgroup analysis, the post-procedural LAA filling velocity, early and late LAA emptying velocities, in addition to the mean velocity of the EM, AM, and SM were significantly higher than before the procedure in patients with LVEF of < 50% and E/Em ratios of > 15.
Conclusions: LAA function improved soon after the TAVI procedure, especially in patients with low LVEF and marked LV diastolic dysfunction.
Keywords
transcatheter aortic valve implantation, left atrial appendage, echocardiography
About this articleTitle
Short-term effects of transcatheter aortic valve implantation on left atrial appendage function
Journal
Issue
Pages
527-534
Published online
2015-10-27
Page views
1871
Article views/downloads
1443
DOI
10.5603/CJ.a2015.0024
Pubmed
Bibliographic record
Cardiol J 2015;22(5):527-534.
Keywords
transcatheter aortic valve implantation
left atrial appendage
echocardiography
Authors
Serkan Aslan
Mehmet Gul
Huseyin Altug Cakmak
Derya Ozturk
Omer Celik
Muhammet Hulusi Satilmisoglu
Safa Gode
Omer Tasbulak
Aydin Yildirim
Ihsan Bakir
