Speckle tracking strain and ECG heterogeneity correlate in transcatheter aortic valve replacement-induced left bundle branch blocks and right ventricular paced rhythms
| Autor: | James Chang, Bruna Araujo Silva, Gordon M. Burke, Alexandre A. Marum, Sarah Fostello, Bruce D. Nearing, Richard L. Verrier, Michael J. Chen, Jeffrey J. Popma, Alexandre L. Bortolotto |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Transcatheter aortic electrocardiography Heart Ventricles medicine.medical_treatment Bundle-Branch Block artificial Paced Rhythm Ventricular Function Left Transcatheter Aortic Valve Replacement Postoperative Complications Rhythm Valve replacement Internal medicine medicine Diseases of the circulatory (Cardiovascular) system Humans cardiovascular diseases Retrospective Studies Aged 80 and over Ejection fraction medicine.diagnostic_test business.industry Left bundle branch block Aortic Valve Stenosis medicine.disease pacemaker Echocardiography RC666-701 Valvular Heart Disease Cardiology Female Transthoracic echocardiogram Cardiology and Cardiovascular Medicine business Electrocardiography Follow-Up Studies |
| Zdroj: | Open Heart Open Heart, Vol 8, Iss 2 (2021) |
| ISSN: | 2053-3624 |
| Popis: | ObjectiveTranscatheter aortic valve replacement (TAVR) complications include left bundle branch block (LBBB) and right ventricular paced rhythm (RVP). We hypothesised that changes in electrocardiographic heterogeneity would correlate better with speckle tracking strain measures than with left ventricular ejection fraction (LVEF) on transthoracic echocardiogram (TTE) among patients with TAVR-induced conduction abnormalities.MethodsWe reviewed medical records of 446 consecutive patients who underwent TAVR at our institution. Of the 238 patients with 12-lead electrocardiograms (ECGs) that met our inclusion criteria, 58 had pre-TAVR and post-TAVR TTEs adequate for strain assessment. We compared patients who did not have an LBBB or RVP pre-TAVR and post-TAVR (controls, n=11) with patients who developed LBBBs (n=11) and who required RVPs (n=10) post-TAVR. In our study population (n=32, 41% female, mean age 85.8 years), we evaluated QRS complex duration, R-wave heterogeneity (RWH), T-wave heterogeneity (TWH), LVEF, global longitudinal strain (GLS) and mechanical dispersion (MD).ResultsTAVR-induced changes on ECG did not correlate with LVEF. TAVR-induced changes in MD and QRS complex duration correlated among all patients (r=0.4, p=0.04). GLS and RWH correlated among RVP patients (r=0.7, p=0.00003). MD and TWH correlated among LBBB patients (r=0.7, p=0.00004).ConclusionsIn this convenience sample of patients with TAVR-induced conduction abnormalities, RWH and TWH correlated with strain measures but not with LVEF. Strain measures, RWH and TWH may offer additional insights for pre-TAVR evaluation and post-TAVR clinical management. |
| Databáze: | OpenAIRE |
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