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

Stens, NA ORCID: 0000-0001-7487-151X, van Iersel, O, Rooijakkers, MJP ORCID: 0000-0002-6815-7667, van Wely, MH, Nijveldt, R ORCID: 0000-0003-1530-6363, Bakker, EA, Rodwell, L, Pedersen, ALD ORCID: 0000-0002-3258-5192, Poulsen, SH, Kjønås, D, Stassen, J ORCID: 0000-0001-9745-5498, Bax, JJ, Tanner, FC, Lerakis, S, Shimoni, S, Poulin, F, Ferreira, V ORCID: 0000-0002-8957-9279, Luksic, VR, van Royen, N and Thijssen, DHJ ORCID: 0000-0002-7707-5567 (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 and Exercise Sciences
Publisher:	Elsevier
Date of acceptance:	3 January 2023
Date of first compliant Open Access:	6 March 2024
Date Deposited:	21 Nov 2023 11:27
Last Modified:	04 Jul 2025 16:00
DOI or ID number:	10.1016/j.jcmg.2023.01.005
URI:	https://researchonline.ljmu.ac.uk/id/eprint/21800

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