Evaluation of the Effect of Transcatheter Aortic Valve Implantation on Left Ventricular Function by 4-Dimensional Echocardiography.

Abstract

Objective: Bene���cial e���ects of transaortic valve implantation on left ventricular hemodynamics and prognosis of patients have been demonstrated. Although left ventricular systolic and diastolic function following transaortic valve implantation procedure have been examined in previous studies, 4-dimensional echocardiographic parameters have not been extensively studied, especially in patients with preserved ejection fraction aortic stenosis. In our study, we planned to evaluate the e���ect of transaortic valve implantation on myocardial deformation using 4-dimensional echocardiography.

Methods: A total of 60 consecutive patients who underwent transaortic valve implantation for severe aortic stenosis with preserved ejection fraction were prospectively enrolled in the study. Standard 2-dimensional echocardiography and 4-dimensional echocardiography were performed in all patients before and 6 months after the transaortic valve implantation procedure.

Results: Six months after valve implantation, signi���cant improvement was observed in global longitudinal strain (P < 0.001), spherical circumferential strain (P = 0.022), global radial strain (P = 0.008), and global area strain (P < 0.001). In the regression analysis, global area strain and absence of diabetes mellitus were determined as independent predictors to show a 10% increase in the left ventricular ejection fraction.

Conclusions: In patients with preserved ejection fraction who underwent transaortic valve implantation, left ventricle deformation parameters have improved after 6 months, especially by using 4-dimensional echocardiography. The use of 4-dimensional echocardiography should be more common in daily practice.