Echo after Transcatheter aortic valve implantation (TAVI) in Medina Cardiac Centre

Introduction In patients (pts) with aortic valve stenosis (AS), it has been demonstrated that left atrium (LA) mechanics assessed by speckle tracking echocardiography (STE) were reduced compared with controls. LA strain and strain rate parameters are more affected in AS than in pts with hypertension, despite a similar extent of left ventricle (LV) hypertrophy and LA dilatation. Reverse remodeling process of LA post aortic valve replacement was observed in many studies. The aim of this study was to assess LA remodeling and LV diastolic functions after Transcatheter Aortic Valve Implantation (TAVI). Methodology All patients who had TAVI in the period of 2013 and 2016 at Medina Cardiac Centre were included. LA functions were assessed by STE using TOMTEC software before and 12 ± 3 months after TAVI. In apical 2 chamber view, the average Peak negative strain of left wall of LA, right wall of LA and LA roof were determined. LA volumes and LV diastolic parameters were measured. Results Eighty patients with severe symptomatic AS were retrospectively enrolled (79.5 ± 4Y, aortic valve area 0.73 ± 0.4cm 2 and Logistic Euro score 15.0 ± 13.9. At 12 ± 3 months post TAVI LA diastolic volume index decreased from 36.1 ± 5.3 mL/m 2 to 33.9  ± 4.6 mL/m 2 (P = 0.2), LA systolic volume index decreased from 24.7 ± 4.5 mL/m 2 to 20.7 ± 3.9 mL/m 2 (p = 0.3) and LA fraction improved from 20.5 ± 3.1% to 24 ± 3.5% (P = 0.5).The average peak negative LA strain was low at −8.2 ± 7.1% and improved to −13.1 ± 6.8% (P = 0.02). LA strain rate improved from −0.79 ± 0.48 s-1 to −1.12 ± 0.36 s-1 (P = 0.05). The Diastolic parameters including E/A ratio, deceleration time and E/ e- are significantly improved. E/A ratio improved from 1.68 ± 0.5 to 1.2 ± 0.4 (P  Conclusion Significant improvement of LA mechanical parameters assessed by STE reflects improvement of LA remodeling and recovery of LV diastolic function post TAVI.