Global longitudinal strain and NT-proBNP as predictors for LV function recovery after TAVR

Abstract Introduction Abnormal GLS values as well high plasma levels of NT-proBNP previous to TAVR are independent predictors for higher peri-procedural mortality. Moreover, in a subgroup patients LV function does not recover following the procedure. Until today, it is still unclear how predict impaired post-procedural optimal clinical patient's management. Purpose This study was set up assess predictive value baseline and on recovery (LVfr) cohort with severe AS referred TAVR. Methods A total 25 (9 male, 84±5 yo, EF 50±11%) (AVA 0.6±0.3 cm2, MPG 49±16 mmHg) were included. Blood analysis TTE performed before intervention (baseline, bl) at follow-up (fu). Myocardial work analysed offline integrating longitudinal strain afterload pressure (SBP + AVPmean). LVfr defined <−19% fu. The median bl (1781 ng/L) (−15%) taken cut-off categorize 4 groups: NT-proBNPhighGLShigh, NT-proBNPlowGLShigh, NT-proBNPhighGLSlow NT-proBNPlowGLSlow. ROC curve prediction after performed. Results recovered 13 (52%). Despite similar global MWI TAVR, contraction became more efficient evidenced by significant improvement (bl vs fu, p<0.05) (−14±4.5 −18±4.2%), MWW (400±510 157±107 mmHg%) MWE (88±6 92±6%) together reduction (203±38 156±22 mmHg, p<0.05). In NT-proBNPlow groups, (−15±4 −20±3%, MCW (2166±874 2978±634 mmHg%, fu significantly better when compared NT-proBNPhigh groups. Likewise, GLSlow groups showed (47±10 54±6%, (2181±832 2961±715 than GLShigh Interestingly, had lower LVESV (57±38 29±10 ml, LVEDV (113±49 80±20 post-TAVR which suggests positive remodelling reduction. At analysis, combined each parameter alone, AUC 0.86 (Fig. 1). Additionally, only 20% seen NT-proBNPhighGLShigh group contrast 67–75% other Conclusion Elevated leads physiological GLS. Although decrease beneficially affects may lead LVfr, this observed whom remained follow-up. We speculate that myocardial tissue damage fibrosis due long lasting exposure partly be responsible observation. combination pre-procedural shows strong potential larger studies warranted further evaluation determination. Funding Acknowledgement Type funding sources: Foundation. Main source(s): Cardiovascular Research Center Aalst (npo)