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April 30, 2024 article Aachen paper

Left and right ventricular longitudinal systolic function following aortic valve replacement in the PARTNER 2 trial and registry

European Heart Journal - Cardiovascular Imaging, vol. 25, pp. 1276–1286

DOI: 10.1093/ehjci/jeae114 OpenAlex

Abstract

AIMS: Evaluation of left and right ventricular (RV) longitudinal systolic function may enhance risk stratification following aortic valve replacement (AVR). The study objective was to evaluate the changes in left and RV longitudinal systolic function and RV-pulmonary artery (RV-PA) coupling from baseline to 30 days and 1 year after AVR. METHODS AND RESULTS: Left ventricular (LV) longitudinal strain (LS), tricuspid annulus plane systolic excursion (TAPSE), and RV-PA coupling were evaluated in patients from the PARTNER 2A surgical AVR (SAVR) arm (n = 985) and from the PARTNER 2 SAPIEN 3 registry (n = 719). TAPSE and RV-PA coupling decreased significantly following SAVR, but remained stable following TAVR. Lower LV LS, TAPSE, or RV-PA coupling at baseline was associated with increased risk of the composite of death, hospitalization, and stroke at 5 years [adjusted hazard ratios (HRs) for LV LS < 15%: 1.24, 95% confidence interval (CI) 1.05-1.45, P = 0.001; TAPSE < 14 mm: 1.44, 95% CI 1.21-1.73, P < 0.001; RV-PA coupling < 0.55 mm/mmHg: 1.32, 95% CI 1.07-1.63, P = 0.011]. Reduced TAPSE at baseline was the most powerful predictor of the composite endpoint at 5 years. Patients with LV ejection fraction <50% at baseline had increased risk of the primary endpoint with SAVR (HR: 1.34, 95% CI 1.08-1.68, P = 0.009) but not with TAVR (HR: 1.12, 95% CI 0.88-1.42). Lower RV-PA coupling at 30 days showed the strongest association with cardiac mortality. CONCLUSION: SAVR but not TAVR was associated with a marked deterioration in RV longitudinal systolic function and RV-PA coupling. Lower TAPSE and RV-PA coupling at 30 days were associated with inferior clinical outcomes at 5 years. In patients with LVEF < 50%, TAVR was associated with superior 5-year outcomes.

Authors 29

  1. Iria Silva

    Hospital Universitario Central de Asturias · Institut universitaire de cardiologie et de pneumologie de Québec · Université Laval

    Affiliation as printed

    Department of Cardiology, Central University Hospital of Asturias , Oviedo , Spain

    Department of Cardiology, Québec Heart & Lung Institute, Laval University , 2725 chemin Ste-Foy, Quebec City, Québec G1V-4G5 , Canada

  2. Julien Ternacle

    Hôpital Cardiologique du Haut-Lévêque

    Affiliation as printed

    Haut-Leveque Cardiology Hospital, Bordeaux University , Pessac , France

  3. Mohamed Salah-Annabi
    Affiliation as printed

    Department of Cardiology, Hôpital de Papineau , Gatineau, Québec , Canada

  4. Abdellaziz Dahou

    St. Francis Hospital

    Affiliation as printed

    St Francis Hospital & Heart Center , New York, NY, USA

  5. Laura Krapf

    Hôpital Cardiologique du Haut-Lévêque

    Affiliation as printed

    Haut-Leveque Cardiology Hospital, Bordeaux University , Pessac , France

  6. Erwan Salaün

    Institut universitaire de cardiologie et de pneumologie de Québec · Université Laval

    Affiliation as printed

    Department of Cardiology, Québec Heart & Lung Institute, Laval University , 2725 chemin Ste-Foy, Quebec City, Québec G1V-4G5 , Canada

  7. Ezéquiel Guzzetti
    Affiliation as printed

    Département de cardiologie, Centre Hospitalier Affilié Universitaire Régional , Trois-Rivières, Québec , Canada

  8. Ke Xu

    Edwards Lifesciences (United States)

    Affiliation as printed

    Edwards Lifesciences , Irvine, CA , USA

  9. Marie-Annick A Clavel

    Institut universitaire de cardiologie et de pneumologie de Québec · Université Laval

    Affiliation as printed

    Department of Cardiology, Québec Heart & Lung Institute, Laval University , 2725 chemin Ste-Foy, Quebec City, Québec G1V-4G5 , Canada

  10. Mathieu Bernier

    Institut universitaire de cardiologie et de pneumologie de Québec · Université Laval

    Affiliation as printed

    Department of Cardiology, Québec Heart & Lung Institute, Laval University , 2725 chemin Ste-Foy, Quebec City, Québec G1V-4G5 , Canada

  11. Jonathan Beaudoin

    Institut universitaire de cardiologie et de pneumologie de Québec · Université Laval

    Affiliation as printed

    Department of Cardiology, Québec Heart & Lung Institute, Laval University , 2725 chemin Ste-Foy, Quebec City, Québec G1V-4G5 , Canada

  12. Paul C Cremer

    Cleveland Clinic

    Affiliation as printed

    Department of Cardiology, Cleveland Clinic , Cleveland, OH , USA

  13. Wael A. Jaber

    Cleveland Clinic

    Affiliation as printed

    Department of Cardiology, Cleveland Clinic , Cleveland, OH , USA

  14. Leonardo Rodríguez

    Cleveland Clinic

    Affiliation as printed

    Department of Cardiology, Cleveland Clinic , Cleveland, OH , USA

  15. Federico M. Asch

    Georgetown University · MedStar Heart & Vascular Institute

    Affiliation as printed

    Cardiovascular Core Laboratories, MedStar Heart and Vascular Institute and Georgetown University , Washington, DC , USA

  16. Neil J Weismann

    Georgetown University · MedStar Heart & Vascular Institute

    Affiliation as printed

    Cardiovascular Core Laboratories, MedStar Heart and Vascular Institute and Georgetown University , Washington, DC , USA

  17. Jeroen Joost Bax Aachen Hart Long Centrum Leiden

    Leiden University

    Affiliation as printed

    Hart Long Centrum Leiden, Leiden University , Leiden , The Netherlands

  18. Nina Ajmone Aachen Hart Long Centrum Leiden

    Leiden University

    Affiliation as printed

    Hart Long Centrum Leiden, Leiden University , Leiden , The Netherlands

  19. Maria C. Alu

    Columbia University Irving Medical Center · Cardiovascular Research Foundation

    Affiliation as printed

    Division of Cardiology, Columbia University Irving Medical Center; Presbyterian Hospital; Cardiovascular Research Foundation , New York, NY , USA

  20. Faouzi Kallel

    Edwards Lifesciences (United States)

    Affiliation as printed

    Edwards Lifesciences , Irvine, CA , USA

  21. Michael J. Mack
    Affiliation as printed

    Department of Cardiovascular and Thoracic Surgery, Baylor Scott & White Cardiac Surgery Specialists , Plano, TX , USA

  22. John G. Webb

    Vancouver General Hospital

    Affiliation as printed

    Centre for Cardiovascular Innovation, St Paul’s and Vancouver General Hospital , Vancouver , Canada

  23. Samir Ramesh Kapadia

    Cleveland Clinic

    Affiliation as printed

    Department of Cardiology, Cleveland Clinic , Cleveland, OH , USA

  24. Raj Makkar

    Cedars-Sinai Medical Center · Cedars-Sinai Smidt Heart Institute

    Affiliation as printed

    Smidt Heart Institute, Cedars-Sinai Medical Center , Los Angeles, CA , USA

  25. Susheel Kodali

    Columbia University Irving Medical Center · Columbia University

    Affiliation as printed

    Department of Medicine, Columbia University Medical Center , New York, NY, USA

  26. Howard C. Herrmann

    University of Pennsylvania

    Affiliation as printed

    Division of Cardiology, University of Pennsylvania , Philadelphia, PA , USA

  27. Vinod H. Thourani
    Affiliation as printed

    Department of Cardiovascular Surgery, Marcus Valve Center, Piedmont Heart Institute , Atlanta, GA , USA

  28. Martin B. Leon

    Columbia University Irving Medical Center · Columbia University

    Affiliation as printed

    Department of Medicine, Columbia University Medical Center , New York, NY, USA

  29. Philippe Pîbarot corresponding

    Institut universitaire de cardiologie et de pneumologie de Québec · Université Laval

    Affiliation as printed

    Department of Cardiology, Québec Heart & Lung Institute, Laval University , 2725 chemin Ste-Foy, Quebec City, Québec G1V-4G5 , Canada

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References 32