Impact of transcatheter aortic valve replacement on left ventricular myocardial work - correlation with right ventricular function parameters

Abstract Background Transcatheter aortic valve replacement (TAVR) has been shown to promote left ventricular (LV) reverse remodeling and functional improvement in patients (pts) with severe aortic stenosis (AS). Evidence regarding its impact on LV performance assessed by advanced speckle-tracking echocardiography (STE) is still limited. We aimed to evaluate the short-term effects of TAVR on LV remodeling and to explore the relationship between post-procedural myocardial work (MW) indices and baseline echocardiographic parameters. Methods We enrolled 199 pts with severe AS who underwent TAVR between 2017-2024. A comprehensive echo was performed just before and one month after the procedure, including STE for myocardial deformation analysis. Complete data on myocardial mechanics was available in 40 pts(75.8±7.6 yrs, 67.5%men). For the calculation of MW indices–global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE), the LV pressure was estimated non-invasively by adding the mean aortic gradient to the brachial systolic pressure to adjust for LV afterload. Results Following TAVR, a significant reduction in LV mass index(LVMi) was observed (151.6±39.6 vs 171.7±47.9g/m²,p