Impact of paravalvular leak on left ventricular remodeling and global longitudinal strain 1 year after transcatheter aortic valve replacement

Abstract

Background: New mild or persistent moderate paravalvular leak (PVL) is a known predictor of poor outcomes after transcatheter aortic valve replacement (TAVR). Its impact on left ventricular (LV) remodeling and global longitudinal strain (GLS) has not been well studied. Materials & methods: We collected echocardiographic data in 99 TAVR patients. LV remodeling and GLS were compared between patients with and without PVL. Results: Patients without PVL (n = 84) had significant LV ejection fraction, wall thickness and LV mass improvement compared with patients with PVL (n = 15; p < 0.001 for all). Diastolic function worsened in patients with PVL. Baseline GLS improved significantly regardless of PVL (p = 0.016 and p = 0.01, respectively) and was not predictive of LV ejection fraction or LV mass improvement when analyzed in tertiles. Conclusion: PVL impedes reverse LV remodeling but not GLS improvement 1-year after TAVR. Baseline GLS was not a predictor of LV remodeling.

Keywords: global longitudinal strain; paravalvular leak; transcatheter aortic valve replacement.