BACKGROUND After transcatheter aortic valve replacement (TAVR), changes in left ventricular (LV) function are partly influenced by the vascular afterload. The burden of thoracic aorta calcification is a component of vascular afterload. OBJECTIVE To assess changes in LV systolic function measured with global longitudinal strain (GLS) in relation to the burden of thoracic aorta calcification in patients with severe aortic stenosis treated with TAVR. METHODS Calcification of the thoracic aorta was estimated on noncontrast computed tomography in 210 patients (50% male, 80 ± 7 years) undergoing TAVR. Conventional and speckle-tracking echocardiography were performed at baseline (prior to TAVR) and 3-6 months and 12 months after TAVR. Patients were divided according to tertiles of calcification burden of the thoracic aorta. RESULTS At baseline, patients within the first tertile of thoracic aorta calcification (0-1,395 Hounsfield Units, HU) had better LV systolic function (LV ejection fraction [LVEF], 47% ± 9%; and LV GLS, -15% ± 5%) as compared with the second tertile (1,396-4,634 HU; LVEF, 46% ± 10%; and LV GLS, -14% ± 4%), and the third tertile (>4,634 HU; LVEF, 44% ± 10%; and LV GLS, -12% ± 4%). During follow-up, patients within tertile 1 of calcification of thoracic aorta achieved significantly better LV systolic function and larger regression of LV mass at 12 months of follow-up than patients within the other tertiles. This pattern was more pronounced in patients with reduced LVEF at baseline. CONCLUSIONS After TAVR, LVEF and GLS improves and LV mass index is reduced significantly at 3-6 and 12 months of follow-up. Patients within the lowest burden of thoracic aorta calcification achieved the best values of LVEF and LV GLS at 1-year follow-up.

中文翻译：

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经胸主动脉钙化负荷后经导管主动脉瓣植入后左心室总纵向应变的变化。

背景技术经导管主动脉瓣置换术（TAVR）后，左心室（LV）功能的变化部分受到血管后负荷的影响。胸主动脉钙化的负担是血管后负荷的一部分。目的评估在用TAVR治疗的严重主动脉瓣狭窄患者中，以整体纵向应变（GLS）测量的LV收缩功能与胸主动脉钙化负担相关的变化。方法采用非对比计算机体层摄影术对210例行TAVR的患者（50％男性，80±7岁）进行胸主动脉钙化评估。在基线（TAVR之前）以及TAVR后3-6个月和12个月进行常规超声和斑点跟踪超声心动图检查。根据胸主动脉钙化负担的三分位数对患者进行分类。结果在基线，胸主动脉钙化的第一三分位患者（0-1395霍恩斯菲尔德单位，HU）患者的左室收缩功能更好（左室射血分数[LVEF]为47％±9％；左室GLS为-15％±5％）第二个三分位数（1,396-4,634 HU; LVEF，46％±10％; LV GLS，-14％±4％），第三个三分位数（> 4,634 HU; LVEF，44％±10％;和LV GLS ，-12％±4％）。在随访期间，与其他三分位数患者相比，随访12个月时，主动脉钙化三分位数1范围内的患者左室收缩功能明显改善，左室重量消退更大。在基线时LVEF降低的患者中，这种模式更为明显。结论TAVR后，随访3-6个月和12个月，LVEF和GLS改善，LV质量指数显着降低。