Effect of transcatheter aortic valve replacement on left atrial function

Vien T. Truong, Eugene Chung, Sherif Nagueh, Dean Kereiakes, Jennifer Schaaf, Brian Volz, Tam N.M. Ngo, Wojciech Mazur

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Objectives: To investigate the effect of transcatheter aortic valve replacement on left atrial volumetric function and left atrial volume for the prediction of adverse outcomes. Methods: This is a retrospective analysis of 121 patients in sinus rhythm who underwent TAVR for severe AS. Maximum LA volume index (LAVI max), minimum LA volume index (LAVI min), and “pre-A” volume index (LAVIpre-A, the volume before atrial contraction) were measured by biplane Simpson's method at baseline, 1 month, and 1 year. The reservoir function, conduit function, booster pump function were calculated. All patients were followed for new-onset of atrial fibrillation, hospitalization and all-cause mortality. Results: The reservoir function, conduit function and booster function before TAVR were 46%, 21%, 32%, respectively. LA volumetric function assessment demonstrated that reservoir function, conduit function increased over the time (all P < 0.01). There was no difference in booster function after TAVR (P = 0.18). Baseline markedly enlarged LA was significantly increased for AF (HR: 4.72; 95% CI, 1.11-20.13, P = 0.04). In addition, There was a progressive decrease in LAVI max (P = 0.02) and RVSP (P = 0.03) over the time in non-AF group but not in AF group (P = 0.62 and P = 0.65, respectively). Although, the proportion of high left ventricular filling pressure decreased in both groups but a marked decrease was noted in non AF group in compared with AF group. Conclusion: Reservoir function, conduit function increased over time. Lack of negative LA remodeling post TAVR was associated with higher incidence of AF.

Original languageEnglish (US)
Pages (from-to)1713-1720
Number of pages8
JournalEchocardiography
Volume35
Issue number11
DOIs
StatePublished - Nov 2018

Keywords

  • LA booster function
  • LA conduit function
  • LA reservoir function
  • LV filling pressure
  • left atrial volume

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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