Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2022; 10(6): 1806-1814
Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1806
Change and impact of left ventricular global longitudinal strain during transcatheter aortic valve implantation
Han Zhang, Jin-Jie Xie, Rong-Juan Li, Yue-Li Wang, Bao-Rong Niu, Li Song, Jing Li, Ya Yang
Han Zhang, Jin-Jie Xie, Rong-Juan Li, Yue-Li Wang, Bao-Rong Niu, Li Song, Jing Li, Ya Yang, Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
Author contributions: Zhang H, Xie JJ, Li RJ, Wang YL, Niu BR, Song L, Li J, and Yang Y contributed to the writing and revising of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Beijing Anzhen Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya Yang, PhD, Chief Physician, Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China. echoyangya6666@163.com
Received: November 24, 2021
Peer-review started: November 24, 2021
First decision: December 9, 2021
Revised: January 4, 2022
Accepted: January 17, 2022
Article in press: January 17, 2022
Published online: February 26, 2022
ARTICLE HIGHLIGHTS
Research background

The efficacy of transcatheter aortic valve implantation (TAVI) and prognosis of aortic stenosis (AS) is usually restricted by perioperative adverse events. Global longitudinal strain is a commonly used echocardiographic parameter for the detection of left ventricular function. Whether there is an association between the changes in global longitudinal strain and the occurrence of perioperative adverse events during TAVI remains unknow.

Research motivation

If global longitudinal strain is useful for the predication of perioperative adverse events, monitoring of global longitudinal strain can be carried out before the operation and corresponding measures can be taken to reduce the operational risk.

Research objectives

To assess changes in left ventricular global longitudinal strain (LVGLS) during the surgery of TAVI and the association between LVGLS and perioperative adverse events in patients with calcified aortic stenosis.

Research methods

A retrospective study was carried in 61 patients with calcified AS undergoing TAVI. These patients underwent standard echocardiography examination. LVEF and LVGLS data were collected during preoperative balloon expansion, preoperative stent implantation, and balloon expansion-stent implantation. The patients were categorized into a normal left ventricular ejection fraction (LVEF) group and a reduced LVEF group, and the normal LVEF group was further stratified into a normal LVGLS subgroup and an increased LVGLS subgroup. The association between changes in LVEF and LVGLS and the occurrence of perioperative adverse events were analyzed.

Research results

In the preserved LVEF group, LVEF only showed obvious change in preoperative balloon expansion section, while LVGLS declined significantly in both preoperative balloon expansion and preoperative stent implantation sections. In the decreased LVEF group, neither LVEF nor LVGLS displayed significant changes. Changes in LVGLS in preoperative balloon expansion section and preoperative stent implantation section were associated with perioperative adverse events which indicating changes in LVGLS during TAVI may have an influence on the occurrence of perioperative adverse events.

Research conclusions

In the preserved LVEF group, changes in LVGLS were greater than in LVEF. LVGLS can be a marker to be used for the prediction of changes in cardiac function during TAVI.

Research perspectives

The optimal cut-off value for LVGLS and timing for measurement of LVGLS still needs to be guaranteed by large scale multi-center studies.