2019 Volume 47 Issue 3 Pages 115-124
Background: Electrocardiographic (ECG) strain pattern has been reported as a poor prognostic factor in patients with aortic stenosis (AS). However, there is no evidence regarding the prevalence of changes in ECG strain and its clinical impact following aortic valve replacement (AVR). This study aimed to investigate the prevalence and prognostic impact of changes in ECG strain pattern after surgical and transcatheter AVR (TAVR).
Methods: Data on 129 patients who underwent AVR (TAVR: 84 cases, 65%) were retrospectively evaluated. The ECG and echocardiographic findings of all included patients were evaluated before and 1 year after AVR. We also assessed freedom from all-cause death and hospitalization for heart failure as clinical outcomes.
Results: Of the 129 patients, 53 (41.1%) had ECG strain before undergoing AVR, and in 32 of these patients (60.4%), ECG strain had normalized one year after undergoing AVR. The Sokolow-Lyon voltage at baseline, AS severity, and AVR type did not differ significantly with or without ECG normalization. Multivariate analysis showed that AVR was not associated with ECG normalization. There was no difference in the clinical outcomes between patients with and without ECG strain or between patients with and without ECG normalization. Cox proportional hazard analysis revealed that increased AS severity, prolonged QT interval, and AVR type were associated with clinical outcomes.
Conclusion: In approximately 60% of the patients, ECG strain normalized regardless of the AVR type. Although ECG strain and normalization after AVR did not affect prognosis, further prospective studies in larger populations are required.
