930 Full Evaluation of Left and Right Atrial Function After Tavi Implantation

Abstract

Aims patients with severe aortic stenosis (AS) experience an increase in left ventricular filling pressure. This leads to changes in the structure and a deterioration in the function of the left (LA) and right (RA) atrium. Patients undergoing TAVI usually experience a reduction in the filling pressure of the left ventricle, thereby decreasing the wall tension of the atria in a retrograde way. The aim of this study was to demonstrate that patients with severe AS, undergoing TAVI, experience a positive remodeling of left and right atrium, with an improvement of their function. Methods and results we enrolled 38 symptomatic patients with severe AS (mean age 84,75 ± 12 years, 60% male, and pre-TAVI aortic valve area 0.75 ± 0.25 cm2 and mean gradient 47,96 ± 23 mmHg). 2D transthoracic echocardiography and 2D speckle tracking echocardiography at baseline and 12 months of follow up were performed. The variation of continuous variables was evaluated using a Student's T test for paired data. P values < 0.05 were considered significant. When compared to baseline, at 12 months a statistically significant improvement was observed for RA strain (p < 0.001) and LA (biplane) strain reservoir, conduction and contraction (p < 0.001, p < 0.012 and p < 0.001, respectively). The LA FE increased significantly (26.01 ± 9.16 vs 32.66 ± 10.95; p < 0.001). After TAVI, the LA (biplane) strain reservoir/end systolic volume ratio increased by 0.33 ± 0.18 to 0.49 ± 0.26 (p > 0.001). Left atrial end-systolic and end-diastolic volume decreased significantly (p > 0.001). Conclusion within 12 months after TAVI, there was a reverse LA and RA remodeling and an improvement in strain reservoir, condunction and contraction function. Also, there was a significant improvement of LA (biplane) strain reservoir/end systolic volume ratio.