Baseline global longitudinal strain by computed tomography is associated with post transcatheter aortic valve replacement outcomes

Computed tomography angiography derived global longitudinal strain (CTA-GLS) has been shown to be feasible, however its prognostic value remains unclear in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). We evaluated the association of baseline CTA-GLS with outcomes including all-cause mortality and composite endpoint of death and heart failure hospitalization in 223 patients treated with TAVR. Patients with normal LVEF but reduced CTA-GLS had similar event rate to those with impaired LVEF, and higher than those with normal LVEF and preserved CTA-GLS. Baseline CTA-GLS assessment might be helpful in patients with difficult echocardiographic images undergoing TAVR evaluation.
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Source Type: research

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Serum B-type natriuretic peptide (BNP) and the N-terminal pro-form, NT-proBNP, which are produced by the cleavage of proBNP are well known predictors of prognosis in heart failure.1 Values correlate with the severity of aortic stenosis (AS) and are associated with symptomatic status and adverse clinical outcomes.2-5 However, the risk stratification of patients with moderate AS is still incipient and predictors of poor outcomes have not been clearly established. Some of these patients may have concomitant comorbidities that may evaluation more complex.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
This study aimed to evaluate the short-term effects of tolvaptan in ADHF patients with severe AS.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Aim To investigate the effects of transcatheter aortic valve implantation (TAVI) on early recovery of global and segmental myocardial function in patients with severe symptomatic aortic stenosis and preserved left ventricular ejection fraction (LVEF) and to determine if parameters of deformation correlate with outcomes. Methods The echocardiographic (strain analysis) and outcome (hospitalizations because of heart failure and mortality) data of 62 consecutive patients with preserved LVEF (64.54 ± 7.97%) who underwent CoreValve prosthesis implantation were examined. Results Early after TAVI (5 ±...
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Cardiovascular interventions Source Type: research
CONCLUSIONS: These findings from 2 independent Japanese registries suggest that the 2-year risk of all-cause mortality and HF does not differ significantly between TAVI and SAVR groups in real-world practice in Japan. PMID: 32009065 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
AbstractAimsIn patients with aortic stenosis (AS), B ‐type natriuretic peptide (BNP) is a prognostic marker. However, there is little information on the association between BNP and invasive haemodynamics in AS. The aim of the present study was to assess the hitherto not well‐defined relationship between BNP and invasive haemodynamics in patients w ith severe AS undergoing aortic valve replacement (AVR) with a view to understand the link between high BNP and poor prognosis in these patients. In particular, we were interested in the association between BNP and combined pre‐capillary and post‐capillary pulmonary hyper...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
There has been an ongoing evolution in our understanding and subsequent management of the patient with aortic stenosis (AS). Valvular AS presents a mechanical obstruction to ventricular ejection at the aortic valve level, worsens over time, and with the onset of symptoms there is a rapidly declining course resulting in progressive heart failure and death. The advent of surgical aortic valve replacement (SAVR) nearly 60 years ago has been lifesaving for many patients with symptomatic severe AS, restoring quality of life to those with severe limiting symptoms.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Editorial Source Type: research
This study aimed to evaluate the effect of the initial aortic valve replacement (AVR) strategy relative to a conservative strategy on long-term outcomes stratified by age among asymptomatic patients with severe aortic stenosis (AS).Methods and Results:Among 1,808 asymptomatic severe AS patients in the CURRENT AS registry, there were 1,166 patients aged ≥75 years (initial AVR: n=124, and conservative: n=1,042), and 642 patients with age
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Publication date: January 2020Source: Canadian Journal of Cardiology, Volume 36, Issue 1Author(s): Mohammad Alkhalil, Paul Brennan, Conor McQuillan, Reuben Jeganathan, Ganesh Manoharan, Colum G. Owens, Mark S. SpenceAbstractBackgroundTools are needed to identify patients at increased risk after transcatheter aortic valve replacement (TAVR). Indexed stroke volume (SVi) is an echocardiographic measurement that is used for low-gradient aortic stenosis. We studied whether low SVi is a high-risk marker in patients with high-gradient aortic stenosis (HG-AS) and assessed the relationship between SVi and left ventricle (LV) systol...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
AbstractHeart failure with reduced ejection fraction (HFrEF) is common in patients with adult congenital heart disease. Many of the most common congenital defects have a high prevalence of HFrEF, including left-sided obstructive lesions (aortic stenosis, coarctation of the aorta, Shone complex), tetralogy of Fallot, Ebstein anomaly, lesions in which there is a systemic right ventricle, and lesions palliated with a Fontan circulation. However, heart failure with preserved ejection fraction (HFpEF) is also prevalent in all these lesions. Comprehensive evaluation includes physical exam, biomarkers, echocardiography and advanc...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
ConclusionsThis analysis shows that there are 3 distinct phases of cost accumulation from referral to post-TAVR with some potentially modifiable cost drivers in each phase.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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