Pre-TAVI echocardiografische S-golf voorspelt NTproBNP-daling

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an effective treatment for severe aortic stenosis. Despite its efficacy, TAVI carries risks of complications in elderly patients. Prior research indicates that failure to reduce NTproBNP levels post-TAVI increases the risk of mortality and recurrent hospitalizations. The tissue Doppler S wave is an index of longitudinal left ventricular function which may predict poor outcomes following TAVI. OBJECTIVE: The aim of the study was to examine whether pre-TAVI S wave velocities are associated with hemodynamic response to TAVI as assessed by changes in NTproBNP levels. METHODS: This prospective observational study enrolled patients scheduled for elective TAVI who underwent echocardiographic evaluation including TDI S wave measurements. Blood levels of NTproBNP were assessed both before and 3 months after the procedure. Subjects were defined as responders or non-responders (NR) with response defined as a ≥ 30% reduction in NTproBNP levels post-procedure. RESULTS: 185 subjects (mean age 79 ± 9 yrs., 47% male) were included in the study. Response to TAVI was observed in 78 (42%) of the cohort. The NR group had a significantly higher incidence of hypertension (62.3% vs. 37.7%, P = 0.017). Median S wave was 6.96 (3.8-13.7) cm/s in the responders and 5.88 (3.77-12.1) cm/s in the NR (p = 0.001), a finding which remained significant on multivariate analysis (p = 0.004; OR 1.31 95%CI 1.09-1.59). CONCLUSIONS: This study demonstrates that for the first time that the TDI S wave is a significant predictor of NTproBNP reduction following TAVI. Further research is needed to validate these results in larger populations.