Early improvement of the regional and global ventricle function estimated by two-dimensional speckle tracking echocardiography after percutaneous aortic valve implantation speckle tracking after CoreValve implantation

摘要

Background: To assess changes in myocardial deformation and ejection fraction (EF) by two-dimensional speckle tracking echocardiography (2DSTE) after transcatheter aortic valve implantation (TAVI). Methods: A total of 24 patients (50% males, age 78 ± 4 years) were selected for TAVI because of severe aortic stenosis. A comprehensive echocardiographic study was performed before TAVI, at discharge, and after 1-month follow-up. EF was assessed by 2D conventional echocardiography with Simpson method and by 2DSTE. Radial and circumferential strains were evaluated in six segments in the short-axis view at the level of the papillary muscles, and longitudinal strain in six segments in the four-chamber apical view, by means of 2DSTE. All studies were performed with an iE-33 echocardiography device (Philips). Results: At discharge, the mean EF estimated by 2DSTE improved significantly when compared with the basal one (56 ± 7% vs. 51 ± 8%, P < 0.01), while EF by Simpson method did not change (67 ± 9% vs. 64 ± 16%, P = 0.2). At that time, global radial (21.4 ± 9% vs. 11.5 ± 7.6%, P = 0.000), circumferential (-20.7 ± 8% vs. -15.2 ± 7%, P = 0.02), and longitudinal strains (-14.8 ± 6.2% vs. -12 ± 6%, P = 0.02) improved significantly when compared with the basal one. At 1-month follow-up, global radial (20.1 ± 5.6% vs. 21.4 ± 9%, P = 0.88) and circumferential (-20 ± 8% vs. -20.7 ± 8%, P = 0.35) strains did not vary and a new significant improvement was observed in longitudinal global strain (-19.2 ± 6.5% vs. -14.8 ± 6.2%, P = 0.002). Conclusions: A new echocardiographic technique, such as 2DSTE, shows a significant early improvement in global and segmental left ventricular systolic function after TAVI, which could not be detected by conventional methods.