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Prognostic Value of Preprocedural LV Global Longitudinal Strain for Post-TAVR-Related Morbidity and Mortality: A Meta-Analysis

Stens, NA, van Iersel, O, Rooijakkers, MJP, van Wely, MH, Nijveldt, R, Bakker, EA, Rodwell, L, Pedersen, ALD, Poulsen, SH, Kjønås, D, Stassen, J, Bax, JJ, Tanner, FC, Lerakis, S, Shimoni, S, Poulin, F, Ferreira, V, Luksic, VR, van Royen, N and Thijssen, DHJ (2023) Prognostic Value of Preprocedural LV Global Longitudinal Strain for Post-TAVR-Related Morbidity and Mortality: A Meta-Analysis. JACC: Cardiovascular Imaging, 16 (3). pp. 332-341. ISSN 1936-878X

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Abstract

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. (Prognostic value of left ventricular global longitudinal strain in patients with aortic stenosis undergoing Transcatheter Aortic Valve Implantation: a meta-analysis; CRD42021289626)

Item Type: Article
Uncontrolled Keywords: Humans; Aortic Valve Stenosis; Ventricular Dysfunction, Left; Stroke Volume; Prognosis; Retrospective Studies; Predictive Value of Tests; Ventricular Function, Left; Transcatheter Aortic Valve Replacement; Global Longitudinal Strain; aortic stenosis; echocardiography; morbidity; mortality; strain; transcatheter aortic valve replacement; Humans; Transcatheter Aortic Valve Replacement; Ventricular Function, Left; Prognosis; Stroke Volume; Global Longitudinal Strain; Retrospective Studies; Predictive Value of Tests; Aortic Valve Stenosis; Ventricular Dysfunction, Left; 1102 Cardiorespiratory Medicine and Haematology; 1103 Clinical Sciences; Cardiovascular System & Hematology
Subjects: Q Science > QP Physiology
R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: Elsevier
SWORD Depositor: A Symplectic
Date Deposited: 21 Nov 2023 11:27
Last Modified: 21 Nov 2023 11:30
DOI or ID number: 10.1016/j.jcmg.2023.01.005
URI: https://researchonline.ljmu.ac.uk/id/eprint/21800
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