Prognostic role of global work efficiency in patients undergoing transcatheter aortic valve implantation

Abstract Background Non-invasive myocardial work (MW) quantification has emerged in the last years as an alternative echocardiographic tool for function assessment. Its role patients with severe aortic stenosis (AS) after valve implantation (TAVI) not been adequately investigated. Purpose We aimed to evaluate MW indices early markers of LV reverse remodeling within a month TAVI and their prognostic value. Methods results conducted single-centre prospective study, enrolling 88 consecutive (mean age 79.9±6.4 years, 35% males) AS undergoing between April 2018 2021, selected from EffecTAVI registry. Exclusion criteria were prior surgery, atrial fibrillation, left bundle branch block (LBBB) at baseline suboptimal quality imaging. Echocardiographic assessment was performed before 30-day follow-up, including 2D global longitudinal strain (GLS), index (GWI), constructive (GCW), wasted (GWW) efficiency (GWE). peak systolic pressure estimated non-invasively sum blood trans-aortic mean gradient. One procedure, there significant improvement GLS (−18.4±4.2 vs −19.5±4.2%, respectively, p=0.006), reduction GWI (2406±567 1908±479 mmHg%, p<0.001), GCW (2783±616 2202±463 GWW (238±203 173±127 p=0.002). Conversely, MWE did change intervention (90.4±6.2 91.4±5.1%, p=0.113). After TAVI, 32 (36.4%) developed dyssynchrony due LBBB or pacemaker implantation. When population divided according presence absence found only those without (241±229 142±103 mmHg% p<0.001). Consistently, this subgroup, significantly improved (90±7 93±5%, p=0.001), while trend observed who (91±5 89±5%, p=0.110). In overall population, value MWE≤92% associated increased rate cardiovascular events (composite all-cause death rehospitalization heart failure) 1-year follow-up (29.5% 4.8%, long rank p=0.003). multivariable Cox-regression analysis, adjusted confounders, GWE (HR: 0.892, CI: 0.817–0.974; p=0.011) independently follow-up. Conclusions can be detected do develop dyssynchrony. setting, is poor outcome. Thus, could represent evaluation receiving TAVI. Funding Acknowledgement Type funding sources: None.