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- Title
Regional left ventricular function after transapical vs. transfemoral transcatheter aortic valve implantation analysed by cardiacmagnetic resonance feature tracking.
- Authors
Meyer, Christian G.; Frick, Michael; Lotfi, Shahram; Altiok, Ertunc; Koos, Ralf; Kirschfink, Annemarie; Lehrke, Michael; Autschbach, Rüdiger; Hoffmann, Rainer
- Abstract
Aims This study analysed the impact of transapical (TA) vs. transfemoral (TF) access site transcatheter aortic valve implantation (TAVI) on post-procedural regional left ventricular (LV) function using cardiac magnetic resonance (CMR) feature tracking (FT). Methods and results CMR was performed 3 months after TAVI on 44 consecutive patients with normal LV ejection fraction prior to TAVI. Twenty patients had TA-TAVI, and 24 had TF-TAVI. Standard cine imaging was performed in three standard cardiac long-axis views (two-, four- and three-chamber views). Myocardial peak systolic radial strain (PSRS) and peak systolic longitudinal strain (PSLS) were analysed based on CMR-FT considering 49 segments in each of the three views. There were no differences in PSRS and PSLS for the basal and mid-ventricular segments betweenTA- and TF-TAVI groups. In contrast, PSRS and PSLS of apical segments and apical cap were reduced in the TA- compared with the TF-TAVI group (PSRS: 15.7+6.4 vs. 35.9+15.7%, respectively, P , 0.001; PSLS: 28.9+5.3 vs. 216.9+4.3%, respectively, P , 0.001). Comparison of all non-apical segments vs. apical segments and apical cap demonstrated no difference in the TF group (PSRS: 34.6+9.0 vs. 35.9+15.7%; respectively, P ¼ 0.702; PSLS: 217.8+4.6 vs. 216.9+4.3%; respectively, P ¼ 0.802). After TA-TAVI, PSRS and PSLS of the apical segmentswere reduced compared with the non-apical segments (PSRS: 15.7+6.4 vs. 33.5+7.0%, respectively, P , 0.001; PSLS:28.9+5.3 vs.215.5+3.5%, respectively, P , 0.001). Conclusion Apical LV function abnormalities can be detected at 3-month follow-up in all TA-TAVI patients using CMR-FT. TA-TAVI results in significant impairment of apical LV function compared with TF-TAVI.
- Publication
European Heart Journal - Cardiovascular Imaging, 2014, Vol 15, Issue 10, p1168
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jeu103