AI Article Synopsis
- The study examined the impact of new cardiac conduction disturbances (CCDs) on heart function and survival rates in patients undergoing transcatheter aortic valve implantation (TAVI) for severe symptomatic aortic stenosis (AS).
- Out of 95 patients analyzed, 35.7% developed new CCDs post-procedure, affecting left ventricular (LV) function—those with CCDs experienced a decline in systolic function while those without showed improvement.
- Despite these effects on LV performance, long-term survival rates between the two groups were not significantly different, indicating that while CCDs can impair heart function, they do not necessarily influence overall patient survival.
Article Abstract
Objectives: Although procedure-related new cardiac conduction disturbances (CCDs) remain an important issue in transcatheter aortic valve implantation (TAVI), their effect on myocardial function and overall patient outcome remains unclear. The goal of this study was to analyze the influence of procedure-related CCDs on systolic and diastolic LV performance and on patient survival after TAVI.
Methods And Results: Ninety-five patients who underwent TAVI for severe symptomatic aortic stenosis (AS) and had a complete follow-up were evaluated with respect to procedure-related CCDs. Left ventricular (LV) performance was measured using standard echocardiographic parameters and speckle tracking analysis. Survival was assessed during longer-term follow-up (mean: 29.1 ± 16.9 months). After TAVI, the improvement of global LV function expressed as ejection fraction (LVEF; from 45.5 ± 10.0 to 47.8 ± 13.9%, P = .13) was not significant. New CCDs were found in 35.7% of TAVI recipients. A comparison between patients with and without new CCDs showed that LV systolic function improved in those without CCDs, while it tended to deteriorate in patients with CCDs (change in LVEF: 5.5 ± 12.3% vs -4.9% ± 11.5%, P = .001; change in global longitudinal strain (GLS): -1.1 ± 4.6% vs 1.2 ± 4.5%, P = .01). Changes in diastolic function did not differ significantly between the groups (changes in transmitral E/A-ratio: -0.3 ± 0.6 vs -0.5 ± 0.5, P = .1). Kaplan-Meier survival analysis revealed no significant differences between the two cohorts (P = .795).
Conclusion: Procedure-related conduction abnormalities after TAVI lead to an LBBB-related dyssynchrony with impairment of LV performance but not of overall survival.
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| http://dx.doi.org/10.1111/echo.13823 | DOI Listing |
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