Impact of Paravalvular Leak On Left Ventricular Remodeling and Global Longitudinal Strain 1 Year After Transcatheter Aortic Valve Replacement

Abstract

Background: New mild or persistent moderate paravalvular leak (PVL) is a known predictor of poor outcomes after transcatheter aortic valve replacement (TAVR). Its impact on left ventricular (LV) remodeling and global longitudinal strain (GLS) has not been well studied. Materials & methods: We collected echocardiographic data in 99 TAVR patients. LV remodeling and GLS were compared between patients with and without PVL. Results: Patients without PVL (n = 84) had significant LV ejection fraction, wall thickness and LV mass improvement compared with patients with PVL (n = 15; p < 0.001 for all). Diastolic function worsened in patients with PVL. Baseline GLS improved significantly regardless of PVL (p = 0.016 and p = 0.01, respectively) and was not predictive of LV ejection fraction or LV mass improvement when analyzed in tertiles. Conclusion: PVL impedes reverse LV remodeling but not GLS improvement 1-year after TAVR. Baseline GLS was not a predictor of LV remodeling.

Keywords:

• global longitudinal strain
• paravalvular leak
• transcatheter aortic valve replacement

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.