TY - JOUR
T1 - Prognostic Value of Preprocedural LV Global Longitudinal Strain for Post-TAVR-Related Morbidity and Mortality
T2 - A Meta-Analysis
AU - Stens, Niels A.
AU - van Iersel, Odette
AU - Rooijakkers, Max J.P.
AU - van Wely, Marleen H.
AU - Nijveldt, Robin
AU - Bakker, Esmée A.
AU - Rodwell, Laura
AU - Pedersen, Anders L.D.
AU - Poulsen, Steen H.
AU - Kjønås, Didrik
AU - Stassen, Jan
AU - Bax, Jeroen J.
AU - Tanner, Felix C.
AU - Lerakis, Stamatios
AU - Shimoni, Sara
AU - Poulin, Frédéric
AU - Ferreira, Vera
AU - Reskovic Luksic, Vlatka
AU - van Royen, Niels
AU - Thijssen, Dick H.J.
N1 - Publisher Copyright:
© 2023 American College of Cardiology Foundation
PY - 2023/3
Y1 - 2023/3
N2 - Background: Left ventricular ejection fraction (LVEF) demonstrates limited prognostic value for post-transcatheter aortic valve replacement (TAVR) outcomes. Evidence regarding the potential role of left ventricular global longitudinal strain (LV-GLS) in this setting is inconsistent. Objectives: The aim of this systematic review and meta-analysis of aggregated data was to evaluate the prognostic value of preprocedural LV-GLS for post–TAVR-related morbidity and mortality. Methods: The authors searched PubMed, Embase, and Web of Science for studies investigating the association between preprocedural 2-dimensional speckle-tracking–derived LV-GLS and post-TAVR clinical outcomes. An inversely weighted random effects meta-analysis was adopted to investigate the association between LV-GLS vs primary (ie, all-cause mortality) and secondary (ie, major cardiovascular events [MACE]) post-TAVR outcomes. Results: Of the 1,130 identified records, 12 were eligible, all of which had a low-to-moderate risk of bias (Newcastle-Ottawa scale). On average, 2,049 patients demonstrated preserved LVEF (52.6% ± 1.7%), but impaired LV-GLS (−13.6% ± 0.6%). Patients with a lower LV-GLS had a higher all-cause mortality (pooled HR: 2.01; 95% CI: 1.59-2.55) and MACE (pooled odds ratio [OR]: 1.26; 95% CI: 1.08-1.47) risk compared with patients with higher LV-GLS. In addition, each percentage point decrease of LV-GLS (ie, toward 0%) was associated with an increased mortality (HR: 1.06; 95% CI: 1.04-1.08) and MACE risk (OR: 1.08; 95% CI: 1.01-1.15). Conclusions: Preprocedural LV-GLS was significantly associated with post-TAVR morbidity and mortality. This suggests a potential clinically important role of pre-TAVR evaluation of LV-GLS for risk stratification of patients with severe aortic stenosis.
AB - Background: Left ventricular ejection fraction (LVEF) demonstrates limited prognostic value for post-transcatheter aortic valve replacement (TAVR) outcomes. Evidence regarding the potential role of left ventricular global longitudinal strain (LV-GLS) in this setting is inconsistent. Objectives: The aim of this systematic review and meta-analysis of aggregated data was to evaluate the prognostic value of preprocedural LV-GLS for post–TAVR-related morbidity and mortality. Methods: The authors searched PubMed, Embase, and Web of Science for studies investigating the association between preprocedural 2-dimensional speckle-tracking–derived LV-GLS and post-TAVR clinical outcomes. An inversely weighted random effects meta-analysis was adopted to investigate the association between LV-GLS vs primary (ie, all-cause mortality) and secondary (ie, major cardiovascular events [MACE]) post-TAVR outcomes. Results: Of the 1,130 identified records, 12 were eligible, all of which had a low-to-moderate risk of bias (Newcastle-Ottawa scale). On average, 2,049 patients demonstrated preserved LVEF (52.6% ± 1.7%), but impaired LV-GLS (−13.6% ± 0.6%). Patients with a lower LV-GLS had a higher all-cause mortality (pooled HR: 2.01; 95% CI: 1.59-2.55) and MACE (pooled odds ratio [OR]: 1.26; 95% CI: 1.08-1.47) risk compared with patients with higher LV-GLS. In addition, each percentage point decrease of LV-GLS (ie, toward 0%) was associated with an increased mortality (HR: 1.06; 95% CI: 1.04-1.08) and MACE risk (OR: 1.08; 95% CI: 1.01-1.15). Conclusions: Preprocedural LV-GLS was significantly associated with post-TAVR morbidity and mortality. This suggests a potential clinically important role of pre-TAVR evaluation of LV-GLS for risk stratification of patients with severe aortic stenosis.
KW - aortic stenosis
KW - echocardiography
KW - morbidity
KW - mortality
KW - strain
KW - transcatheter aortic valve replacement
UR - http://www.scopus.com/inward/record.url?scp=85149664656&partnerID=8YFLogxK
U2 - 10.1016/j.jcmg.2023.01.005
DO - 10.1016/j.jcmg.2023.01.005
M3 - Article
C2 - 36889849
AN - SCOPUS:85149664656
SN - 1936-878X
VL - 16
SP - 332
EP - 341
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 3
ER -